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ASCENDANT ORTHOPEDIC ALLIANCE, LLC EMPLOYEES' CAFETERIA PLAN 401k Plan overview

Plan NameASCENDANT ORTHOPEDIC ALLIANCE, LLC EMPLOYEES' CAFETERIA PLAN
Plan identification number 501

ASCENDANT ORTHOPEDIC ALLIANCE, LLC EMPLOYEES' CAFETERIA 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

ASCENDANT ORTHOPAEDIC ALLIANCE has sponsored the creation of one or more 401k plans.

Company Name:ASCENDANT ORTHOPAEDIC ALLIANCE
Employer identification number (EIN):814710676
NAIC Classification:621111
NAIC Description:Offices of Physicians (except Mental Health Specialists)

Form 5500 Filing Information

Submission information for form 5500 for 401k plan ASCENDANT ORTHOPEDIC ALLIANCE, LLC EMPLOYEES' CAFETERIA PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012022-01-01ADELBERT J MENCIAS2023-04-14
5012021-01-01ADELBERT MENCIAS2022-06-01
5012020-01-01JAMES SIERADZKI2021-06-04
5012019-01-01
5012018-01-01JAMES SIERADZKI, MD2019-07-29

Plan Statistics for ASCENDANT ORTHOPEDIC ALLIANCE, LLC EMPLOYEES' CAFETERIA PLAN

401k plan membership statisitcs for ASCENDANT ORTHOPEDIC ALLIANCE, LLC EMPLOYEES' CAFETERIA PLAN

Measure Date Value
2022: ASCENDANT ORTHOPEDIC ALLIANCE, LLC EMPLOYEES' CAFETERIA PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-01219
Total number of active participants reported on line 7a of the Form 55002022-01-01206
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 participants2022-01-01206
Number of employers contributing to the scheme2022-01-010
2021: ASCENDANT ORTHOPEDIC ALLIANCE, LLC EMPLOYEES' CAFETERIA PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-01365
Total number of active participants reported on line 7a of the Form 55002021-01-01219
Number of retired or separated participants receiving benefits2021-01-010
Number of other retired or separated participants entitled to future benefits2021-01-010
Total of all active and inactive participants2021-01-01219
Number of employers contributing to the scheme2021-01-010
2020: ASCENDANT ORTHOPEDIC ALLIANCE, LLC EMPLOYEES' CAFETERIA PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-01416
Total number of active participants reported on line 7a of the Form 55002020-01-01364
Number of retired or separated participants receiving benefits2020-01-011
Number of other retired or separated participants entitled to future benefits2020-01-010
Total of all active and inactive participants2020-01-01365
Number of employers contributing to the scheme2020-01-010
2019: ASCENDANT ORTHOPEDIC ALLIANCE, LLC EMPLOYEES' CAFETERIA PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-01407
Total number of active participants reported on line 7a of the Form 55002019-01-01414
Number of retired or separated participants receiving benefits2019-01-012
Number of other retired or separated participants entitled to future benefits2019-01-010
Total of all active and inactive participants2019-01-01416
2018: ASCENDANT ORTHOPEDIC ALLIANCE, LLC EMPLOYEES' CAFETERIA PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-01336
Total number of active participants reported on line 7a of the Form 55002018-01-01407
Number of retired or separated participants receiving benefits2018-01-010
Number of other retired or separated participants entitled to future benefits2018-01-010
Total of all active and inactive participants2018-01-01407

Form 5500 Responses for ASCENDANT ORTHOPEDIC ALLIANCE, LLC EMPLOYEES' CAFETERIA PLAN

2022: ASCENDANT ORTHOPEDIC ALLIANCE, LLC EMPLOYEES' CAFETERIA PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
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
2021: ASCENDANT ORTHOPEDIC ALLIANCE, LLC EMPLOYEES' CAFETERIA PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan funding arrangement – General assets of the sponsorYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement – General assets of the sponsorYes
2020: ASCENDANT ORTHOPEDIC ALLIANCE, LLC EMPLOYEES' CAFETERIA PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan funding arrangement – General assets of the sponsorYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement – General assets of the sponsorYes
2019: ASCENDANT ORTHOPEDIC ALLIANCE, LLC EMPLOYEES' CAFETERIA PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Submission has been amendedNo
2019-01-01This submission is the final filingNo
2019-01-01This return/report is a short plan year return/report (less than 12 months)No
2019-01-01Plan is a collectively bargained planNo
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan funding arrangement – General assets of the sponsorYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement – General assets of the sponsorYes
2018: ASCENDANT ORTHOPEDIC ALLIANCE, LLC EMPLOYEES' CAFETERIA PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01First time form 5500 has been submittedYes
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan funding arrangement – General assets of the sponsorYes
2018-01-01Plan benefit arrangement – InsuranceYes
2018-01-01Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberGL 161656
Policy instance 2
Insurance contract or identification numberGL 161656
Number of Individuals Covered206
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $34,489
Total amount of fees paid to insurance companyUSD $6,507
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT,CRITICAL ILLNESS,ACCIDENT
Welfare Benefit Premiums Paid to CarrierUSD $198,742
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $19,304
Amount paid for insurance broker fees4704
Additional information about fees paid to insurance brokerADMINISTRATIVE AND OTHER FEES
Insurance broker organization code?3
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number1150151
Policy instance 1
Insurance contract or identification number1150151
Number of Individuals Covered450
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $22,513
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $159,106
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $15,911
Amount paid for insurance broker fees0
Insurance broker organization code?3
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract number136-421151
Policy instance 1
Insurance contract or identification number136-421151
Number of Individuals Covered557
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $44,520
Total amount of fees paid to insurance companyUSD $6,154
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT,CRITICAL ILLNESS,ACCIDENT
Welfare Benefit Premiums Paid to CarrierUSD $303,645
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $16,058
Amount paid for insurance broker fees5577
Additional information about fees paid to insurance brokerADMINISTRATIVE AND OTHER FEES
Insurance broker organization code?3
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract number136-421151
Policy instance 1
Insurance contract or identification number136-421151
Number of Individuals Covered407
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $50,974
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT,CRITICAL ILLNESS,ACCIDENT
Welfare Benefit Premiums Paid to CarrierUSD $301,320
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $35,189
Amount paid for insurance broker fees0
Insurance broker organization code?3
HEALTH RESOURCES INC (National Association of Insurance Commissioners NAIC id number: 96687 )
Policy contract number1116170432AA
Policy instance 1
Insurance contract or identification number1116170432AA
Number of Individuals Covered287
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $11,731
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $117,308
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,099
Insurance broker organization code?3
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number30058971
Policy instance 4
Insurance contract or identification number30058971
Number of Individuals Covered155
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $1,221
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $54,668
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $756
Insurance broker organization code?3
HEALTH RESOURCES INC (National Association of Insurance Commissioners NAIC id number: 96687 )
Policy contract number1116170432AS
Policy instance 3
Insurance contract or identification number1116170432AS
Number of Individuals Covered102
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $2,620
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $26,206
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,596
Insurance broker organization code?3
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number94049
Policy instance 2
Insurance contract or identification number94049
Number of Individuals Covered414
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $13,648
Total amount of fees paid to insurance companyUSD $225
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $176,013
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,081
Insurance broker organization code?3
Amount paid for insurance broker fees225
Additional information about fees paid to insurance brokerADMINISTRATIVE FEE
HEALTH RESOURCES INC (National Association of Insurance Commissioners NAIC id number: 96687 )
Policy contract number1116170432AA
Policy instance 2
Insurance contract or identification number1116170432AA
Number of Individuals Covered213
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $16,630
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $166,303
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $16,630
Insurance broker organization code?3
HEALTH RESOURCES INC (National Association of Insurance Commissioners NAIC id number: 96687 )
Policy contract number1116170432AS
Policy instance 1
Insurance contract or identification number1116170432AS
Number of Individuals Covered110
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $4,593
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $45,930
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,593
Insurance broker organization code?3
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number30058971
Policy instance 4
Insurance contract or identification number30058971
Number of Individuals Covered303
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $1,911
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $44,444
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,911
Insurance broker organization code?3
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number94049
Policy instance 3
Insurance contract or identification number94049
Number of Individuals Covered407
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $21,337
Total amount of fees paid to insurance companyUSD $165
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D, SUPPLEMENTAL LIFE
Welfare Benefit Premiums Paid to CarrierUSD $274,734
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $21,337
Insurance broker organization code?3
Amount paid for insurance broker fees165
Additional information about fees paid to insurance brokerADMINISTRATIVE FEE

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