Plan Name | RETINA CONSULTANTS MINNESOTA MSO LLC COMPREHENSIVE HEALTH & WELFARE BENEFITS PLAN |
Plan identification number | 511 |
401k Plan Type | Welfare Benefit |
Plan Features/Benefits |
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Company Name: | RETINA MINNESOTA MSO, LLC |
Employer identification number (EIN): | 852653127 |
NAIC Classification: | 621111 |
NAIC Description: | Offices of Physicians (except Mental Health Specialists) |
Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
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511 | 2023-01-01 | GRETCHEN POFFENBERGER | 2024-07-24 |
Measure | Date | Value |
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2023: RETINA CONSULTANTS MINNESOTA MSO LLC COMPREHENSIVE HEALTH & WELFARE BENEFITS PLAN 2023 401k membership | ||
Total participants, beginning-of-year | 2023-01-01 | 174 |
Total number of active participants reported on line 7a of the Form 5500 | 2023-01-01 | 244 |
Number of retired or separated participants receiving benefits | 2023-01-01 | 1 |
Number of other retired or separated participants entitled to future benefits | 2023-01-01 | 0 |
Total of all active and inactive participants | 2023-01-01 | 245 |
Number of employers contributing to the scheme | 2023-01-01 | 0 |
2023: RETINA CONSULTANTS MINNESOTA MSO LLC COMPREHENSIVE HEALTH & WELFARE BENEFITS PLAN 2023 form 5500 responses | ||
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2023-01-01 | Type of plan entity | Single employer plan |
2023-01-01 | Plan funding arrangement – Insurance | Yes |
2023-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2023-01-01 | Plan benefit arrangement – Insurance | Yes |
2023-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) | |||||||||||||||||||||||||||||||||
Policy contract number | 929429 | ||||||||||||||||||||||||||||||||
Policy instance | 1 | ||||||||||||||||||||||||||||||||
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EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) | |||||||||||||||||||||||||||||||||
Policy contract number | 10084051001 | ||||||||||||||||||||||||||||||||
Policy instance | 2 | ||||||||||||||||||||||||||||||||
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DELTA DENTAL OF MINNESOTA (National Association of Insurance Commissioners NAIC id number: 55034 ) | |||||||||||||||||||||||||||||||||
Policy contract number | T03339 | ||||||||||||||||||||||||||||||||
Policy instance | 3 | ||||||||||||||||||||||||||||||||
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) | |||||||||||||||||||||||||||||||||
Policy contract number | 351166 | ||||||||||||||||||||||||||||||||
Policy instance | 4 | ||||||||||||||||||||||||||||||||
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