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NORTH IDAHO EYE INSTITUTE LIFE AND AD&D 401k Plan overview

Plan NameNORTH IDAHO EYE INSTITUTE LIFE AND AD&D
Plan identification number 501

NORTH IDAHO EYE INSTITUTE LIFE AND AD&D Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Life insurance
  • Death benefits (include travel accident but not life insurance)

401k Sponsoring company profile

NORTH IDAHO EYE INSTITUE has sponsored the creation of one or more 401k plans.

Company Name:NORTH IDAHO EYE INSTITUE
Employer identification number (EIN):820448111
NAIC Classification:621320
NAIC Description:Offices of Optometrists

Form 5500 Filing Information

Submission information for form 5500 for 401k plan NORTH IDAHO EYE INSTITUTE LIFE AND AD&D

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012023-01-01ROBERT TABARACCI2024-07-26
5012022-01-01BARBARA SMITH2023-04-05
5012021-01-01IRENE KLOOS2022-09-09
5012021-01-01ROBERT TABARACCI2023-10-30
5012020-01-01BEN GABY2021-10-04

Plan Statistics for NORTH IDAHO EYE INSTITUTE LIFE AND AD&D

401k plan membership statisitcs for NORTH IDAHO EYE INSTITUTE LIFE AND AD&D

Measure Date Value
2023: NORTH IDAHO EYE INSTITUTE LIFE AND AD&D 2023 401k membership
Total participants, beginning-of-year2023-01-01115
Total number of active participants reported on line 7a of the Form 55002023-01-01125
Number of retired or separated participants receiving benefits2023-01-010
Number of other retired or separated participants entitled to future benefits2023-01-010
Total of all active and inactive participants2023-01-01125
Number of employers contributing to the scheme2023-01-010
2022: NORTH IDAHO EYE INSTITUTE LIFE AND AD&D 2022 401k membership
Total participants, beginning-of-year2022-01-01114
Total number of active participants reported on line 7a of the Form 55002022-01-01115
Number of retired or separated participants receiving benefits2022-01-010
Number of other retired or separated participants entitled to future benefits2022-01-010
Total of all active and inactive participants2022-01-01115
Number of employers contributing to the scheme2022-01-010
2021: NORTH IDAHO EYE INSTITUTE LIFE AND AD&D 2021 401k membership
Total participants, beginning-of-year2021-01-01104
Total number of active participants reported on line 7a of the Form 55002021-01-01114
Number of retired or separated participants receiving benefits2021-01-010
Number of other retired or separated participants entitled to future benefits2021-01-010
Total of all active and inactive participants2021-01-01114
Number of employers contributing to the scheme2021-01-010
2020: NORTH IDAHO EYE INSTITUTE LIFE AND AD&D 2020 401k membership
Total participants, beginning-of-year2020-01-01104
Total number of active participants reported on line 7a of the Form 55002020-01-01104
Number of retired or separated participants receiving benefits2020-01-010
Number of other retired or separated participants entitled to future benefits2020-01-010
Total of all active and inactive participants2020-01-01104
Number of employers contributing to the scheme2020-01-010

Form 5500 Responses for NORTH IDAHO EYE INSTITUTE LIFE AND AD&D

2023: NORTH IDAHO EYE INSTITUTE LIFE AND AD&D 2023 form 5500 responses
2023-01-01Type of plan entitySingle employer plan
2023-01-01Plan funding arrangement – InsuranceYes
2023-01-01Plan benefit arrangement – InsuranceYes
2022: NORTH IDAHO EYE INSTITUTE LIFE AND AD&D 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan benefit arrangement – InsuranceYes
2021: NORTH IDAHO EYE INSTITUTE LIFE AND AD&D 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Submission has been amendedYes
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan benefit arrangement – InsuranceYes
2020: NORTH IDAHO EYE INSTITUTE LIFE AND AD&D 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01First time form 5500 has been submittedYes
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

UNITED HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 63983 )
Policy contract numberGL-3680
Policy instance 1
Insurance contract or identification numberGL-3680
Number of Individuals Covered125
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $588
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $8,253
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNITED HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 63983 )
Policy contract numberGL-3680
Policy instance 1
Insurance contract or identification numberGL-3680
Number of Individuals Covered115
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $456
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $5,719
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $456
Amount paid for insurance broker fees0
Insurance broker organization code?3
UNITED HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 63983 )
Policy contract numberGL-3680
Policy instance 1
Insurance contract or identification numberGL-3680
Number of Individuals Covered114
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $528
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $7,100
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $295
Amount paid for insurance broker fees0
Insurance broker organization code?3
UNITED HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 63983 )
Policy contract number3680
Policy instance 1
Insurance contract or identification number3680
Number of Individuals Covered104
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $562
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $7,688
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $562
Amount paid for insurance broker fees0
Insurance broker organization code?3

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