401k Plan data: ASSOCIATED RETINA CONSULTANTS LTD GROUP INS PLAN plan

ASSOCIATED RETINA CONSULTANTS LTD GROUP INS PLAN 401k Plan overview

Plan Name	ASSOCIATED RETINA CONSULTANTS LTD GROUP INS PLAN
Plan identification number	501

ASSOCIATED RETINA CONSULTANTS LTD GROUP INS PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) Life insurance Dental Long-term disability cover

401k Sponsoring company profile

ASSOCIATED RETINA CONSULTANTS, LTD. has sponsored the creation of one or more 401k plans.

Company Name: ASSOCIATED RETINA CONSULTANTS, LTD.

Employer identification number (EIN): 860285158

NAIC Classification: 541990
NAIC Description: All Other Professional, Scientific, and Technical Services

Form 5500 Filing Information

Submission information for form 5500 for 401k plan ASSOCIATED RETINA CONSULTANTS LTD GROUP INS PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2022-01-01
501 2021-01-01

Plan Statistics for ASSOCIATED RETINA CONSULTANTS LTD GROUP INS PLAN

401k plan membership statisitcs for ASSOCIATED RETINA CONSULTANTS LTD GROUP INS PLAN

Measure Date Value
2022: ASSOCIATED RETINA CONSULTANTS LTD GROUP INS PLAN 2022 401k membership
Total participants, beginning-of-year 2022-01-01 148
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 123
Total of all active and inactive participants 2022-01-01 123
Total participants 2022-01-01 123
2021: ASSOCIATED RETINA CONSULTANTS LTD GROUP INS PLAN 2021 401k membership
Total participants, beginning-of-year 2021-01-01 96
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 148
Total of all active and inactive participants 2021-01-01 148
Total participants 2021-01-01 148

Measure	Date	Value
2022: ASSOCIATED RETINA CONSULTANTS LTD GROUP INS PLAN 2022 401k membership
Total participants, beginning-of-year	2022-01-01	148
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	123
Total of all active and inactive participants	2022-01-01	123
Total participants	2022-01-01	123
2021: ASSOCIATED RETINA CONSULTANTS LTD GROUP INS PLAN 2021 401k membership
Total participants, beginning-of-year	2021-01-01	96
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	148
Total of all active and inactive participants	2021-01-01	148
Total participants	2021-01-01	148

Form 5500 Responses for ASSOCIATED RETINA CONSULTANTS LTD GROUP INS PLAN

2022: ASSOCIATED RETINA CONSULTANTS LTD GROUP INS PLAN 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: ASSOCIATED RETINA CONSULTANTS LTD GROUP INS PLAN 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	Plan funding arrangement – Insurance	Yes
2021-01-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

BLUE CROSS BLUE SHIELD OF ARIZONA (National Association of Insurance Commissioners NAIC id number: 53589 )

Policy contract number

033995

Policy instance

Insurance contract or identification number	033995
Number of Individuals Covered	123
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $50,377
Health Insurance Welfare Benefit	Yes
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $903,277
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $50,377
Additional information about fees paid to insurance broker	GENERAL AGENT/ BROKER PAYMENTS
Insurance broker organization code?	3

UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )

Policy contract number

396342

Policy instance

Insurance contract or identification number	396342
Number of Individuals Covered	90
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $2,810
Life Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $21,259
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,810
Additional information about fees paid to insurance broker	GENERAL AGENT/ BROKER PAYMENTS
Insurance broker organization code?	3

COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 )

Policy contract number

E7472616

Policy instance

Insurance contract or identification number	E7472616
Number of Individuals Covered	59
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $13,945
Total amount of fees paid to insurance company	USD $417
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $95,859
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $13,945
Amount paid for insurance broker fees	417
Insurance broker organization code?	4

BLUE CROSS BLUE SHIELD OF ARIZONA (National Association of Insurance Commissioners NAIC id number: 53589 )

Policy contract number

033995

Policy instance

Insurance contract or identification number	033995
Number of Individuals Covered	148
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Total amount of commissions paid to insurance broker	USD $52,247
Health Insurance Welfare Benefit	Yes
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $984,399
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $40,138
Additional information about fees paid to insurance broker	GENERAL AGENT/ BROKER PAYMENTS
Insurance broker organization code?	3

UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )

Policy contract number

396342

Policy instance

Insurance contract or identification number	396342
Number of Individuals Covered	107
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Total amount of commissions paid to insurance broker	USD $3,775
Life Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $20,792
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $3,380
Additional information about fees paid to insurance broker	GENERAL AGENT/ BROKER PAYMENTS
Insurance broker organization code?	3

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Company Name:	ASSOCIATED RETINA CONSULTANTS, LTD.
Employer identification number (EIN):	860285158
NAIC Classification:	541990
NAIC Description:	All Other Professional, Scientific, and Technical Services