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ENVISION PHYSICIAN SERVICES, LLC HEALTH AND WELFARE BENEFIT AND CAFETERIA PLAN 401k Plan overview

Plan NameENVISION PHYSICIAN SERVICES, LLC HEALTH AND WELFARE BENEFIT AND CAFETERIA PLAN
Plan identification number 501

ENVISION PHYSICIAN SERVICES, LLC HEALTH AND WELFARE BENEFIT AND CAFETERIA PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Dental

401k Sponsoring company profile

ENVISION PHYSICIAN SERVICES, LLC has sponsored the creation of one or more 401k plans.

Company Name:ENVISION PHYSICIAN SERVICES, LLC
Employer identification number (EIN):823024963
NAIC Classification:621111
NAIC Description:Offices of Physicians (except Mental Health Specialists)

Form 5500 Filing Information

Submission information for form 5500 for 401k plan ENVISION PHYSICIAN SERVICES, LLC HEALTH AND WELFARE BENEFIT AND CAFETERIA PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012022-01-01
5012021-01-01
5012020-01-01
5012019-01-01
5012018-01-01
5012018-01-01

Plan Statistics for ENVISION PHYSICIAN SERVICES, LLC HEALTH AND WELFARE BENEFIT AND CAFETERIA PLAN

401k plan membership statisitcs for ENVISION PHYSICIAN SERVICES, LLC HEALTH AND WELFARE BENEFIT AND CAFETERIA PLAN

Measure Date Value
2022: ENVISION PHYSICIAN SERVICES, LLC HEALTH AND WELFARE BENEFIT AND CAFETERIA PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-015,520
Total number of active participants reported on line 7a of the Form 55002022-01-015,117
Number of retired or separated participants receiving benefits2022-01-01115
Number of other retired or separated participants entitled to future benefits2022-01-010
Total of all active and inactive participants2022-01-015,232
2021: ENVISION PHYSICIAN SERVICES, LLC HEALTH AND WELFARE BENEFIT AND CAFETERIA PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-016,387
Total number of active participants reported on line 7a of the Form 55002021-01-015,414
Number of retired or separated participants receiving benefits2021-01-01106
Number of other retired or separated participants entitled to future benefits2021-01-010
Total of all active and inactive participants2021-01-015,520
2020: ENVISION PHYSICIAN SERVICES, LLC HEALTH AND WELFARE BENEFIT AND CAFETERIA PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-015,932
Total number of active participants reported on line 7a of the Form 55002020-01-016,173
Number of retired or separated participants receiving benefits2020-01-01214
Number of other retired or separated participants entitled to future benefits2020-01-010
Total of all active and inactive participants2020-01-016,387
2019: ENVISION PHYSICIAN SERVICES, LLC HEALTH AND WELFARE BENEFIT AND CAFETERIA PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-016,924
Total number of active participants reported on line 7a of the Form 55002019-01-015,753
Number of retired or separated participants receiving benefits2019-01-01179
Number of other retired or separated participants entitled to future benefits2019-01-010
Total of all active and inactive participants2019-01-015,932
2018: ENVISION PHYSICIAN SERVICES, LLC HEALTH AND WELFARE BENEFIT AND CAFETERIA PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-017,368
Total number of active participants reported on line 7a of the Form 55002018-01-016,875
Number of retired or separated participants receiving benefits2018-01-01160
Number of other retired or separated participants entitled to future benefits2018-01-010
Total of all active and inactive participants2018-01-017,035

Financial Data on ENVISION PHYSICIAN SERVICES, LLC HEALTH AND WELFARE BENEFIT AND CAFETERIA PLAN

Measure Date Value
2019 : ENVISION PHYSICIAN SERVICES, LLC HEALTH AND WELFARE BENEFIT AND CAFETERIA PLAN 2019 401k financial data
Total unrealized appreciation/depreciation of assets2019-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$7,736,605
Total income from all sources (including contributions)2019-12-31$96,740,668
Total loss/gain on sale of assets2019-12-31$0
Total of all expenses incurred2019-12-31$90,555,107
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$84,909,655
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$96,740,668
Value of total assets at end of year2019-12-31$0
Value of total assets at beginning of year2019-12-31$1,551,044
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$5,645,452
Total interest from all sources2019-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2019-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-12-31No
Was this plan covered by a fidelity bond2019-12-31Yes
Value of fidelity bond cover2019-12-31$500,000
Were there any nonexempt tranactions with any party-in-interest2019-12-31No
Contributions received from participants2019-12-31$31,126,160
Total non interest bearing cash at end of year2019-12-31$0
Total non interest bearing cash at beginning of year2019-12-31$1,545,000
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Value of net income/loss2019-12-31$6,185,561
Value of net assets at end of year (total assets less liabilities)2019-12-31$0
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$-6,185,561
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2019-12-31No
Were any leases to which the plan was party in default or uncollectible2019-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2019-12-31$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2019-12-31$6,044
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2019-12-31$6,044
Expenses. Payments to insurance carriers foe the provision of benefits2019-12-31$68,368
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-12-31No
Was there a failure to transmit to the plan any participant contributions2019-12-31No
Has the plan failed to provide any benefit when due under the plan2019-12-31No
Contributions received in cash from employer2019-12-31$65,614,508
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-12-31$84,841,287
Contract administrator fees2019-12-31$5,645,452
Liabilities. Value of benefit claims payable at end of year2019-12-31$0
Liabilities. Value of benefit claims payable at beginning of year2019-12-31$7,736,605
Did the plan have assets held for investment2019-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-12-31No
Opinion of an independent qualified public accountant for this plan2019-12-31Unqualified
Accountancy firm name2019-12-31GRANT THORNTON LLP
Accountancy firm EIN2019-12-31366055558
2018 : ENVISION PHYSICIAN SERVICES, LLC HEALTH AND WELFARE BENEFIT AND CAFETERIA PLAN 2018 401k financial data
Total unrealized appreciation/depreciation of assets2018-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$7,736,605
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$0
Total income from all sources (including contributions)2018-12-31$81,715,924
Total loss/gain on sale of assets2018-12-31$0
Total of all expenses incurred2018-12-31$87,901,485
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2018-12-31$82,749,413
Total contributions o plan (from employers,participants, others, non cash contrinutions)2018-12-31$81,715,924
Value of total assets at end of year2018-12-31$1,551,044
Value of total assets at beginning of year2018-12-31$0
Total of administrative expenses incurred including professional, contract, advisory and management fees2018-12-31$5,152,072
Total interest from all sources2018-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2018-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2018-12-31No
Was this plan covered by a fidelity bond2018-12-31Yes
Value of fidelity bond cover2018-12-31$500,000
Were there any nonexempt tranactions with any party-in-interest2018-12-31No
Contributions received from participants2018-12-31$33,257,765
Total non interest bearing cash at end of year2018-12-31$1,545,000
Total non interest bearing cash at beginning of year2018-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Value of net income/loss2018-12-31$-6,185,561
Value of net assets at end of year (total assets less liabilities)2018-12-31$-6,185,561
Value of net assets at beginning of year (total assets less liabilities)2018-12-31$0
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2018-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2018-12-31No
Were any leases to which the plan was party in default or uncollectible2018-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2018-12-31$6,044
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2018-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2018-12-31$0
Expenses. Payments to insurance carriers foe the provision of benefits2018-12-31$36,361
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2018-12-31No
Was there a failure to transmit to the plan any participant contributions2018-12-31No
Has the plan failed to provide any benefit when due under the plan2018-12-31No
Contributions received in cash from employer2018-12-31$48,458,159
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2018-12-31$82,713,052
Contract administrator fees2018-12-31$5,152,072
Liabilities. Value of benefit claims payable at end of year2018-12-31$7,736,605
Liabilities. Value of benefit claims payable at beginning of year2018-12-31$0
Did the plan have assets held for investment2018-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2018-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2018-12-31No
Opinion of an independent qualified public accountant for this plan2018-12-31Unqualified
Accountancy firm name2018-12-31GRANT THORNTON LLP
Accountancy firm EIN2018-12-31366055558

Form 5500 Responses for ENVISION PHYSICIAN SERVICES, LLC HEALTH AND WELFARE BENEFIT AND CAFETERIA PLAN

2022: ENVISION PHYSICIAN SERVICES, LLC HEALTH AND WELFARE BENEFIT AND CAFETERIA PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Submission has been amendedNo
2022-01-01This submission is the final filingNo
2022-01-01This return/report is a short plan year return/report (less than 12 months)No
2022-01-01Plan is a collectively bargained planNo
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: ENVISION PHYSICIAN SERVICES, LLC HEALTH AND WELFARE BENEFIT AND CAFETERIA PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Submission has been amendedNo
2021-01-01This submission is the final filingNo
2021-01-01This return/report is a short plan year return/report (less than 12 months)No
2021-01-01Plan is a collectively bargained planNo
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: ENVISION PHYSICIAN SERVICES, LLC HEALTH AND WELFARE BENEFIT AND CAFETERIA PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Submission has been amendedNo
2020-01-01This submission is the final filingNo
2020-01-01This return/report is a short plan year return/report (less than 12 months)No
2020-01-01Plan is a collectively bargained planNo
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: ENVISION PHYSICIAN SERVICES, LLC HEALTH AND WELFARE BENEFIT AND 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 – TrustYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement - TrustYes
2018: ENVISION PHYSICIAN SERVICES, LLC HEALTH AND WELFARE BENEFIT AND CAFETERIA PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01First time form 5500 has been submittedYes
2018-01-01Submission has been amendedNo
2018-01-01This submission is the final filingNo
2018-01-01This return/report is a short plan year return/report (less than 12 months)No
2018-01-01Plan is a collectively bargained planNo
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

HAWAII MEDICAL SERVICE ASSOCIATION (National Association of Insurance Commissioners NAIC id number: 95804 )
Policy contract numberC97L/C98F
Policy instance 1
Insurance contract or identification numberC97L/C98F
Number of Individuals Covered6
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Are there contracts with allocated funds for individual policies?0
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 BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
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 $48,596
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HAWAII MEDICAL SERVICE ASSOCIATION (National Association of Insurance Commissioners NAIC id number: 95804 )
Policy contract numberC97L/C98F
Policy instance 1
Insurance contract or identification numberC97L/C98F
Number of Individuals Covered10
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Are there contracts with allocated funds for individual policies?0
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 BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
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 $327,143
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HAWAII MEDICAL SERVICE ASSOCIATION (National Association of Insurance Commissioners NAIC id number: 95804 )
Policy contract numberC97L/C98F
Policy instance 1
Insurance contract or identification numberC97L/C98F
Number of Individuals Covered102
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Are there contracts with allocated funds for individual policies?0
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 BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
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 $627,989
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HAWAII MEDICAL SERVICE ASSOCIATION (National Association of Insurance Commissioners NAIC id number: 95804 )
Policy contract numberC91B
Policy instance 1
Insurance contract or identification numberC91B
Number of Individuals Covered85
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Are there contracts with allocated funds for individual policies?0
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 BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
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 $556,055
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HAWAII MEDICAL SERVICE ASSOCIATION (National Association of Insurance Commissioners NAIC id number: 95804 )
Policy contract numberC91B
Policy instance 1
Insurance contract or identification numberC91B
Number of Individuals Covered16
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Are there contracts with allocated funds for individual policies?0
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 BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
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 $36,361
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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