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Plan Name | LAS ISLAS FAMILY MEDICAL GROUP WRAP BENEFIT PLAN |
Plan identification number | 501 |
401k Plan Type | Welfare Benefit |
Plan Features/Benefits |
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Company Name: | LAS ISLAS FAMILY MEDICAL GROUP |
Employer identification number (EIN): | 770285222 |
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 |
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501 | 2020-01-01 | MIGUEL CERVANTES | 2021-06-11 | ||
501 | 2017-12-01 | ||||
501 | 2016-12-01 | MIGUEL CERVANTES | MIGUEL CERVANTES | 2018-09-14 |
Measure | Date | Value |
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2020: LAS ISLAS FAMILY MEDICAL GROUP WRAP BENEFIT PLAN 2020 401k membership | ||
Total participants, beginning-of-year | 2020-01-01 | 197 |
Total number of active participants reported on line 7a of the Form 5500 | 2020-01-01 | 188 |
Number of retired or separated participants receiving benefits | 2020-01-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2020-01-01 | 1 |
Total of all active and inactive participants | 2020-01-01 | 189 |
2017: LAS ISLAS FAMILY MEDICAL GROUP WRAP BENEFIT PLAN 2017 401k membership | ||
Total participants, beginning-of-year | 2017-12-01 | 184 |
Total number of active participants reported on line 7a of the Form 5500 | 2017-12-01 | 184 |
Number of retired or separated participants receiving benefits | 2017-12-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2017-12-01 | 0 |
Total of all active and inactive participants | 2017-12-01 | 184 |
2016: LAS ISLAS FAMILY MEDICAL GROUP WRAP BENEFIT PLAN 2016 401k membership | ||
Total participants, beginning-of-year | 2016-12-01 | 187 |
Total number of active participants reported on line 7a of the Form 5500 | 2016-12-01 | 188 |
Number of retired or separated participants receiving benefits | 2016-12-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2016-12-01 | 0 |
Total of all active and inactive participants | 2016-12-01 | 188 |
2020: LAS ISLAS FAMILY MEDICAL GROUP WRAP BENEFIT PLAN 2020 form 5500 responses | ||
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2020-01-01 | Type of plan entity | Single employer plan |
2020-01-01 | Submission has been amended | No |
2020-01-01 | This submission is the final filing | No |
2020-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2020-01-01 | Plan is a collectively bargained plan | No |
2020-01-01 | Plan funding arrangement – Insurance | Yes |
2020-01-01 | Plan benefit arrangement – Insurance | Yes |
2017: LAS ISLAS FAMILY MEDICAL GROUP WRAP BENEFIT PLAN 2017 form 5500 responses | ||
2017-12-01 | Type of plan entity | Single employer plan |
2017-12-01 | Submission has been amended | No |
2017-12-01 | This submission is the final filing | No |
2017-12-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2017-12-01 | Plan is a collectively bargained plan | No |
2017-12-01 | Plan funding arrangement – Insurance | Yes |
2017-12-01 | Plan benefit arrangement – Insurance | Yes |
2016: LAS ISLAS FAMILY MEDICAL GROUP WRAP BENEFIT PLAN 2016 form 5500 responses | ||
2016-12-01 | Type of plan entity | Single employer plan |
2016-12-01 | First time form 5500 has been submitted | Yes |
2016-12-01 | Submission has been amended | No |
2016-12-01 | This submission is the final filing | No |
2016-12-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2016-12-01 | Plan is a collectively bargained plan | No |
2016-12-01 | Plan funding arrangement – Insurance | Yes |
2016-12-01 | Plan benefit arrangement – Insurance | Yes |
SAFEGUARD HEALTH PLANS, INC. A CALIFORNIA CORPORATION (National Association of Insurance Commissioners NAIC id number: 96030 ) | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Policy contract number | 5932105 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Policy instance | 1 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Policy contract number | 5932105 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Policy instance | 2 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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CALIFORNIA PHYSICIANS SERVICE (National Association of Insurance Commissioners NAIC id number: 47732 ) | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Policy contract number | W0070362 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Policy instance | 3 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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SAFEGUARD HEALTH PLANS, INC. A CALIFORNIA CORPORATION (National Association of Insurance Commissioners NAIC id number: 96030 ) | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Policy contract number | 5932105 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Policy instance | 1 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Policy contract number | KM05932105 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Policy instance | 2 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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