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ST. PAUL RADIOLOGY VISION 401k Plan overview

Plan NameST. PAUL RADIOLOGY VISION
Plan identification number 503

ST. PAUL RADIOLOGY VISION Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Vision
  • Unfunded, fully insured, or combination unfunded/insured welfare plan that will not file a Form 5500 for next plan year pursuant to 29 CFR 2520.104-20.
  • Unfunded, fully insured, or combination unfunded/insured welfare plan that stopped filing form 5500s in an earlier plan year pursuant to 29 CFR 2520.104-20.

401k Sponsoring company profile

MIDWEST RADIOLOGY, P.A. has sponsored the creation of one or more 401k plans.

Company Name:MIDWEST RADIOLOGY, P.A.
Employer identification number (EIN):410916626
NAIC Classification:621111
NAIC Description:Offices of Physicians (except Mental Health Specialists)

Form 5500 Filing Information

Submission information for form 5500 for 401k plan ST. PAUL RADIOLOGY VISION

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5032019-01-01BARRY LINDO2020-07-14
5032019-01-01TERESA HOFFBECK2021-07-04
5032017-01-01

Plan Statistics for ST. PAUL RADIOLOGY VISION

401k plan membership statisitcs for ST. PAUL RADIOLOGY VISION

Measure Date Value
2019: ST. PAUL RADIOLOGY VISION 2019 401k membership
Total participants, beginning-of-year2019-01-01102
Total number of active participants reported on line 7a of the Form 55002019-01-01212
Number of retired or separated participants receiving benefits2019-01-010
Number of other retired or separated participants entitled to future benefits2019-01-010
Total of all active and inactive participants2019-01-01212
Number of employers contributing to the scheme2019-01-010
2017: ST. PAUL RADIOLOGY VISION 2017 401k membership
Total participants, beginning-of-year2017-01-01100
Total number of active participants reported on line 7a of the Form 55002017-01-0191
Number of retired or separated participants receiving benefits2017-01-010
Number of other retired or separated participants entitled to future benefits2017-01-010
Total of all active and inactive participants2017-01-0191

Form 5500 Responses for ST. PAUL RADIOLOGY VISION

2019: ST. PAUL RADIOLOGY VISION 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
2017: ST. PAUL RADIOLOGY VISION 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01First time form 5500 has been submittedYes
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number98364201001
Policy instance 1
Insurance contract or identification number98364201001
Number of Individuals Covered497
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $2,254
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Welfare Benefit Premiums Paid to CarrierUSD $28,475
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,254
Amount paid for insurance broker fees0
Insurance broker organization code?3
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number9836420
Policy instance 1
Insurance contract or identification number9836420
Number of Individuals Covered214
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $1,219
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $12,492
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,219
Amount paid for insurance broker fees0
Insurance broker organization code?3
Insurance broker nameGALLAGHER BENEFIT SERVICES, INC.

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