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| Plan Name | MIAMI BEACH MEDICAL GROUP HEALTH PLAN |
| Plan identification number | 501 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | MIAMI BEACH MEDICAL GROUP |
| Employer identification number (EIN): | 650603933 |
| 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 |
|---|---|---|---|---|---|
| 501 | 2020-05-01 | ||||
| 501 | 2019-05-01 | ||||
| 501 | 2017-05-01 | XAVIER ALARCON |
| Measure | Date | Value |
|---|---|---|
| 2020: MIAMI BEACH MEDICAL GROUP HEALTH PLAN 2020 401k membership | ||
| Total participants, beginning-of-year | 2020-05-01 | 359 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-05-01 | 566 |
| Total of all active and inactive participants | 2020-05-01 | 566 |
| 2019: MIAMI BEACH MEDICAL GROUP HEALTH PLAN 2019 401k membership | ||
| Total participants, beginning-of-year | 2019-05-01 | 318 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-05-01 | 359 |
| Total of all active and inactive participants | 2019-05-01 | 359 |
| 2017: MIAMI BEACH MEDICAL GROUP HEALTH PLAN 2017 401k membership | ||
| Total participants, beginning-of-year | 2017-05-01 | 335 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-05-01 | 335 |
| Total of all active and inactive participants | 2017-05-01 | 335 |
| 2020: MIAMI BEACH MEDICAL GROUP HEALTH PLAN 2020 form 5500 responses | ||
|---|---|---|
| 2020-05-01 | Type of plan entity | Single employer plan |
| 2020-05-01 | Submission has been amended | No |
| 2020-05-01 | This submission is the final filing | No |
| 2020-05-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2020-05-01 | Plan is a collectively bargained plan | No |
| 2020-05-01 | Plan funding arrangement – Insurance | Yes |
| 2020-05-01 | Plan benefit arrangement – Insurance | Yes |
| 2019: MIAMI BEACH MEDICAL GROUP HEALTH PLAN 2019 form 5500 responses | ||
| 2019-05-01 | Type of plan entity | Single employer plan |
| 2019-05-01 | Submission has been amended | No |
| 2019-05-01 | This submission is the final filing | No |
| 2019-05-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2019-05-01 | Plan is a collectively bargained plan | No |
| 2019-05-01 | Plan funding arrangement – Insurance | Yes |
| 2019-05-01 | Plan benefit arrangement – Insurance | Yes |
| 2017: MIAMI BEACH MEDICAL GROUP HEALTH PLAN 2017 form 5500 responses | ||
| 2017-05-01 | Type of plan entity | Single employer plan |
| 2017-05-01 | First time form 5500 has been submitted | Yes |
| 2017-05-01 | Submission has been amended | No |
| 2017-05-01 | This submission is the final filing | No |
| 2017-05-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2017-05-01 | Plan is a collectively bargained plan | No |
| 2017-05-01 | Plan funding arrangement – Insurance | Yes |
| 2017-05-01 | Plan benefit arrangement – Insurance | Yes |
| AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 ) | |
| Policy contract number | 24580 |
| Policy instance | 8 |
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) | |
| Policy contract number | 10242046 |
| Policy instance | 1 |
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) | |
| Policy contract number | 10242042 |
| Policy instance | 2 |
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) | |
| Policy contract number | 400242044 |
| Policy instance | 3 |
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) | |
| Policy contract number | 10242043 |
| Policy instance | 4 |
| HUMANA MEDICAL PLAN, INC. (National Association of Insurance Commissioners NAIC id number: 95270 ) | |
| Policy contract number | 826056 |
| Policy instance | 5 |
| COMPBENEFITS COMPANY (National Association of Insurance Commissioners NAIC id number: 52015 ) | |
| Policy contract number | 826056 |
| Policy instance | 6 |
| HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 ) | |
| Policy contract number | 826056 |
| Policy instance | 7 |
| AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 ) | |
| Policy contract number | 24580 |
| Policy instance | 8 |
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) | |
| Policy contract number | 10242043 |
| Policy instance | 7 |
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) | |
| Policy contract number | 1D037176 |
| Policy instance | 6 |
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) | |
| Policy contract number | 400242045 |
| Policy instance | 5 |
| HUMANA (National Association of Insurance Commissioners NAIC id number: 95270 ) | |
| Policy contract number | 826056 |
| Policy instance | 4 |
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) | |
| Policy contract number | 10242042 |
| Policy instance | 3 |
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) | |
| Policy contract number | 10242046 |
| Policy instance | 2 |
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) | |
| Policy contract number | 400242044 |
| Policy instance | 1 |
| COMPBENEFITS COMPANY (National Association of Insurance Commissioners NAIC id number: 52015 ) | |
| Policy contract number | 694521 |
| Policy instance | 2 |
| AVMED HEALTH PLANS (National Association of Insurance Commissioners NAIC id number: 95263 ) | |
| Policy contract number | 123397/8,127548 |
| Policy instance | 3 |
| TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 ) | |
| Policy contract number | 24801 |
| Policy instance | 4 |
| AVMED HEALTH PLANS (National Association of Insurance Commissioners NAIC id number: 95263 ) | |
| Policy contract number | 127550,1,549 |
| Policy instance | 5 |
| HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 ) | |
| Policy contract number | 694521 |
| Policy instance | 1 |
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