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CHURCHILL ADMINISTRATIVE SERVICES VISION 401k Plan overview

Plan NameCHURCHILL ADMINISTRATIVE SERVICES VISION
Plan identification number 503

CHURCHILL ADMINISTRATIVE SERVICES VISION 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.
  • Unfunded, fully insured, or combination unfunded/insured welfare plan that stopped filing form 5500s in an earlier plan year pursuant to 29 CFR 2520.104-20.

401k Sponsoring company profile

CHURCHILL ADMINISTRATIVE SERVICES, LLC has sponsored the creation of one or more 401k plans.

Company Name:CHURCHILL ADMINISTRATIVE SERVICES, LLC
Employer identification number (EIN):811093064
NAIC Classification:531110
NAIC Description:Lessors of Residential Buildings and Dwellings

Additional information about CHURCHILL ADMINISTRATIVE SERVICES, LLC

Jurisdiction of Incorporation: Texas Secretary of State
Incorporation Date: 2016-01-08
Company Identification Number: 0802365326
Legal Registered Office Address: 5605 N MACARTHUR BLVD STE 580

IRVING
United States of America (USA)
75038

More information about CHURCHILL ADMINISTRATIVE SERVICES, LLC

Form 5500 Filing Information

Submission information for form 5500 for 401k plan CHURCHILL ADMINISTRATIVE SERVICES VISION

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5032019-10-01SANDY KLIDAS2021-07-13
5032017-10-01SANDY KLIDAS2019-06-20
5032016-10-01SANDY KLIDAS
5032016-05-01SANDY KLIDAS SANDY KLIDAS2017-05-18
5032015-05-01BRADLEY E. FORSLUND
5032015-05-01

Plan Statistics for CHURCHILL ADMINISTRATIVE SERVICES VISION

401k plan membership statisitcs for CHURCHILL ADMINISTRATIVE SERVICES VISION

Measure Date Value
2019: CHURCHILL ADMINISTRATIVE SERVICES VISION 2019 401k membership
Total participants, beginning-of-year2019-10-01100
Total number of active participants reported on line 7a of the Form 55002019-10-0152
Number of retired or separated participants receiving benefits2019-10-010
Number of other retired or separated participants entitled to future benefits2019-10-010
Total of all active and inactive participants2019-10-0152
Number of employers contributing to the scheme2019-10-010
2017: CHURCHILL ADMINISTRATIVE SERVICES VISION 2017 401k membership
Total participants, beginning-of-year2017-10-01185
Total number of active participants reported on line 7a of the Form 55002017-10-0158
Number of retired or separated participants receiving benefits2017-10-010
Number of other retired or separated participants entitled to future benefits2017-10-010
Total of all active and inactive participants2017-10-0158
Number of employers contributing to the scheme2017-10-010
2016: CHURCHILL ADMINISTRATIVE SERVICES VISION 2016 401k membership
Total participants, beginning-of-year2016-10-0178
Total number of active participants reported on line 7a of the Form 55002016-10-0179
Number of retired or separated participants receiving benefits2016-10-010
Number of other retired or separated participants entitled to future benefits2016-10-010
Total of all active and inactive participants2016-10-0179
Total participants, beginning-of-year2016-05-01109
Total number of active participants reported on line 7a of the Form 55002016-05-0178
Number of retired or separated participants receiving benefits2016-05-010
Number of other retired or separated participants entitled to future benefits2016-05-010
Total of all active and inactive participants2016-05-0178
2015: CHURCHILL ADMINISTRATIVE SERVICES VISION 2015 401k membership
Total participants, beginning-of-year2015-05-01101
Total number of active participants reported on line 7a of the Form 55002015-05-01109
Number of retired or separated participants receiving benefits2015-05-010
Number of other retired or separated participants entitled to future benefits2015-05-010
Total of all active and inactive participants2015-05-01109

Form 5500 Responses for CHURCHILL ADMINISTRATIVE SERVICES VISION

2019: CHURCHILL ADMINISTRATIVE SERVICES VISION 2019 form 5500 responses
2019-10-01Type of plan entitySingle employer plan
2019-10-01Plan funding arrangement – InsuranceYes
2019-10-01Plan benefit arrangement – InsuranceYes
2017: CHURCHILL ADMINISTRATIVE SERVICES VISION 2017 form 5500 responses
2017-10-01Type of plan entitySingle employer plan
2017-10-01Plan funding arrangement – InsuranceYes
2017-10-01Plan benefit arrangement – InsuranceYes
2016: CHURCHILL ADMINISTRATIVE SERVICES VISION 2016 form 5500 responses
2016-10-01Type of plan entitySingle employer plan
2016-10-01Submission has been amendedNo
2016-10-01This submission is the final filingNo
2016-10-01This return/report is a short plan year return/report (less than 12 months)No
2016-10-01Plan is a collectively bargained planNo
2016-10-01Plan funding arrangement – InsuranceYes
2016-10-01Plan benefit arrangement – InsuranceYes
2016-05-01Type of plan entitySingle employer plan
2016-05-01Submission has been amendedNo
2016-05-01This submission is the final filingNo
2016-05-01This return/report is a short plan year return/report (less than 12 months)Yes
2016-05-01Plan is a collectively bargained planNo
2016-05-01Plan funding arrangement – InsuranceYes
2016-05-01Plan benefit arrangement – InsuranceYes
2015: CHURCHILL ADMINISTRATIVE SERVICES VISION 2015 form 5500 responses
2015-05-01Type of plan entitySingle employer plan
2015-05-01First time form 5500 has been submittedYes
2015-05-01Submission has been amendedYes
2015-05-01This submission is the final filingNo
2015-05-01This return/report is a short plan year return/report (less than 12 months)No
2015-05-01Plan is a collectively bargained planNo
2015-05-01Plan funding arrangement – InsuranceYes
2015-05-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number98771501001
Policy instance 1
Insurance contract or identification number98771501001
Number of Individuals Covered123
Insurance policy start date2019-10-01
Insurance policy end date2020-09-30
Total amount of commissions paid to insurance brokerUSD $594
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $5,934
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $594
Amount paid for insurance broker fees0
Insurance broker organization code?3
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number98771501001
Policy instance 1
Insurance contract or identification number98771501001
Number of Individuals Covered136
Insurance policy start date2017-10-01
Insurance policy end date2018-09-30
Total amount of commissions paid to insurance brokerUSD $852
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $8,324
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 number9877150
Policy instance 1
Insurance contract or identification number9877150
Number of Individuals Covered186
Insurance policy start date2015-05-01
Insurance policy end date2016-04-30
Total amount of commissions paid to insurance brokerUSD $0
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 $8,555
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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