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ENT MSO, LLC DBA ELEVATE ENT PARTNERS HEALTH & WELFARE PLAN 401k Plan overview

Plan NameENT MSO, LLC DBA ELEVATE ENT PARTNERS HEALTH & WELFARE PLAN
Plan identification number 501

ENT MSO, LLC DBA ELEVATE ENT PARTNERS HEALTH & WELFARE 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

ENT MSO, LLC has sponsored the creation of one or more 401k plans.

Company Name:ENT MSO, LLC
Employer identification number (EIN):650303665
NAIC Classification:621111
NAIC Description:Offices of Physicians (except Mental Health Specialists)

Form 5500 Filing Information

Submission information for form 5500 for 401k plan ENT MSO, LLC DBA ELEVATE ENT PARTNERS HEALTH & WELFARE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012023-01-01ELLEN CHARLETON2024-08-06
5012022-01-01ELLEN CHARLETON2023-08-28
5012022-01-01ELLEN CHARLETON2023-11-16

Plan Statistics for ENT MSO, LLC DBA ELEVATE ENT PARTNERS HEALTH & WELFARE PLAN

401k plan membership statisitcs for ENT MSO, LLC DBA ELEVATE ENT PARTNERS HEALTH & WELFARE PLAN

Measure Date Value
2023: ENT MSO, LLC DBA ELEVATE ENT PARTNERS HEALTH & WELFARE PLAN 2023 401k membership
Total participants, beginning-of-year2023-01-01337
Total number of active participants reported on line 7a of the Form 55002023-01-011,164
Number of retired or separated participants receiving benefits2023-01-010
Number of other retired or separated participants entitled to future benefits2023-01-010
Total of all active and inactive participants2023-01-011,164
Number of employers contributing to the scheme2023-01-010
2022: ENT MSO, LLC DBA ELEVATE ENT PARTNERS HEALTH & WELFARE PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-01453
Total number of active participants reported on line 7a of the Form 55002022-01-01337
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 participants2022-01-01337
Number of employers contributing to the scheme2022-01-010

Form 5500 Responses for ENT MSO, LLC DBA ELEVATE ENT PARTNERS HEALTH & WELFARE PLAN

2023: ENT MSO, LLC DBA ELEVATE ENT PARTNERS HEALTH & WELFARE PLAN 2023 form 5500 responses
2023-01-01Type of plan entityMulitple employer plan
2023-01-01Plan funding arrangement – InsuranceYes
2023-01-01Plan funding arrangement – General assets of the sponsorYes
2023-01-01Plan benefit arrangement – InsuranceYes
2023-01-01Plan benefit arrangement – General assets of the sponsorYes
2022: ENT MSO, LLC DBA ELEVATE ENT PARTNERS HEALTH & WELFARE PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Submission has been amendedYes
2022-01-01Plan is a collectively bargained planYes
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan funding arrangement – General assets of the sponsorYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number97854 0001
Policy instance 6
Insurance contract or identification number97854 0001
Number of Individuals Covered14
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $4,407
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedLONG TERM CARE
Welfare Benefit Premiums Paid to CarrierUSD $29,379
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MARQUEE HEALTH (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number00
Policy instance 5
Insurance contract or identification number00
Number of Individuals Covered703
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Other welfare benefits providedWELLNESS
Welfare Benefit Premiums Paid to CarrierUSD $49,051
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number50006131001
Policy instance 4
Insurance contract or identification number50006131001
Number of Individuals Covered1127
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $6,758
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $69,143
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number5391404
Policy instance 3
Insurance contract or identification number5391404
Number of Individuals Covered1027
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $43,784
Total amount of fees paid to insurance companyUSD $8,157
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $426,989
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
ZURICH AMERICAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 90537 )
Policy contract numberCLPEX01191
Policy instance 2
Insurance contract or identification numberCLPEX01191
Number of Individuals Covered1164
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $79,811
Total amount of fees paid to insurance companyUSD $10,445
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT, EMPLOYEE ASSISTANCE PROGRAM
Welfare Benefit Premiums Paid to CarrierUSD $532,073
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number176224
Policy instance 1
Insurance contract or identification number176224
Number of Individuals Covered1037
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $217,081
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $7,824,580
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number97854 0001
Policy instance 6
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number50006131001
Policy instance 5
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number5391404
Policy instance 4
CONTINENTAL AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71730 )
Policy contract number27859
Policy instance 3
ZURICH AMERICAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 90557 )
Policy contract numberCLPEX01191
Policy instance 2
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number176224
Policy instance 1

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