| Plan Name | NORTH IDAHO EYE INSTITUTE, PA TELEMEDICINE |
| Plan identification number | 503 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
|
| Company Name: | NORTH IDAHO EYE INSTITUE |
| Employer identification number (EIN): | 820448111 |
| NAIC Classification: | 621320 |
| NAIC Description: | Offices of Optometrists |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 503 | 2023-01-01 | ROBERT TABARACCI | 2024-07-26 | ||
| 503 | 2022-01-01 | BARBARA SMITH | 2023-04-05 | ||
| 503 | 2021-01-01 | IRENE KLOOS | 2022-09-09 | ||
| 503 | 2021-01-01 | ROBERT TABARACCI | 2023-10-30 |
| 2023: NORTH IDAHO EYE INSTITUTE, PA TELEMEDICINE 2023 form 5500 responses | ||
|---|---|---|
| 2023-01-01 | Type of plan entity | Single employer plan |
| 2023-01-01 | Plan funding arrangement – Insurance | Yes |
| 2023-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2022: NORTH IDAHO EYE INSTITUTE, PA TELEMEDICINE 2022 form 5500 responses | ||
| 2022-01-01 | Type of plan entity | Single employer plan |
| 2022-01-01 | Plan funding arrangement – Insurance | Yes |
| 2022-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2021: NORTH IDAHO EYE INSTITUTE, PA TELEMEDICINE 2021 form 5500 responses | ||
| 2021-01-01 | Type of plan entity | Single employer plan |
| 2021-01-01 | First time form 5500 has been submitted | Yes |
| 2021-01-01 | Submission has been amended | Yes |
| 2021-01-01 | Plan funding arrangement – Insurance | Yes |
| 2021-01-01 | Plan benefit arrangement – Insurance | Yes |
| ALLY HEALTH (National Association of Insurance Commissioners NAIC id number: 54199 ) | |||||||||||||||||||
| Policy contract number | ALH050611 | ||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||
| |||||||||||||||||||
| ALLY HEALTH (National Association of Insurance Commissioners NAIC id number: 54199 ) | |||||||||||||||||||
| Policy contract number | ALH050611 | ||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||
| |||||||||||||||||||
| ALLY HEALTH (National Association of Insurance Commissioners NAIC id number: 54199 ) | |||||||||||||||||||
| Policy contract number | ALH050611 | ||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||