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| Plan Name | KISMET LIFE AND DISABILITY PLANS |
| Plan identification number | 504 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | KISMET NEW VISION HOLDINGS |
| Employer identification number (EIN): | 852124790 |
| NAIC Classification: | 621493 |
| NAIC Description: | Freestanding Ambulatory Surgical and Emergency Centers |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 504 | 2020-08-17 | RHONDA SEBASTIAN | 2021-06-23 |
| 2020: KISMET LIFE AND DISABILITY PLANS 2020 form 5500 responses | ||
|---|---|---|
| 2020-08-17 | Type of plan entity | Single employer plan |
| 2020-08-17 | First time form 5500 has been submitted | Yes |
| 2020-08-17 | This submission is the final filing | Yes |
| 2020-08-17 | This return/report is a short plan year return/report (less than 12 months) | Yes |
| 2020-08-17 | Plan funding arrangement – Insurance | Yes |
| 2020-08-17 | Plan benefit arrangement – Insurance | Yes |
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) | |
| Policy contract number | 5973314 |
| Policy instance | 1 |
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