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ADAPT, INC. VISION PLAN 401k Plan overview

Plan NameADAPT, INC. VISION PLAN
Plan identification number 503

ADAPT, INC. VISION PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Vision

401k Sponsoring company profile

ADAPT has sponsored the creation of one or more 401k plans.

Company Name:ADAPT
Employer identification number (EIN):930611783
NAIC Classification:621420
NAIC Description:Outpatient Mental Health and Substance Abuse Centers

Additional information about ADAPT

Jurisdiction of Incorporation: Oregon Secretary of State Corporations Division
Incorporation Date: 1971-06-10
Company Identification Number: 9334517
Legal Registered Office Address: 621 W MADRONE ST

ROSEBURG
United States of America (USA)
97470

More information about ADAPT

Form 5500 Filing Information

Submission information for form 5500 for 401k plan ADAPT, INC. VISION PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5032019-01-01GRAYSON BLY2020-05-19
5032019-01-01GRAYSON BLY2021-02-18
5032018-01-01

Plan Statistics for ADAPT, INC. VISION PLAN

401k plan membership statisitcs for ADAPT, INC. VISION PLAN

Measure Date Value
2019: ADAPT, INC. VISION PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-01188
Total number of active participants reported on line 7a of the Form 55002019-01-01199
Number of retired or separated participants receiving benefits2019-01-011
Number of other retired or separated participants entitled to future benefits2019-01-010
Total of all active and inactive participants2019-01-01200
Number of employers contributing to the scheme2019-01-010
2018: ADAPT, INC. VISION PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-01174
Total number of active participants reported on line 7a of the Form 55002018-01-01188
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 participants2018-01-01188
Number of employers contributing to the scheme2018-01-010

Form 5500 Responses for ADAPT, INC. VISION PLAN

2019: ADAPT, INC. VISION PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Submission has been amendedYes
2019-01-01This submission is the final filingYes
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan benefit arrangement – InsuranceYes
2018: ADAPT, INC. VISION 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 benefit arrangement – InsuranceYes

Insurance Providers Used on plan

VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number30054966
Policy instance 1
Insurance contract or identification number30054966
Number of Individuals Covered202
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 $23,852
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,221
Amount paid for insurance broker fees0
Insurance broker organization code?3
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number30054966
Policy instance 1
Insurance contract or identification number30054966
Number of Individuals Covered164
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $1,140
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $21,139
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,140
Amount paid for insurance broker fees0
Insurance broker organization code?3

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