401k Plan data: AVASURE MEDICAL PLAN plan

AVASURE MEDICAL PLAN 401k Plan overview

Plan Name	AVASURE MEDICAL PLAN
Plan identification number	501

AVASURE MEDICAL PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision)

401k Sponsoring company profile

AVASURE OPCO HOLDINGS, LLC has sponsored the creation of one or more 401k plans.

Company Name: AVASURE OPCO HOLDINGS, LLC

Employer identification number (EIN): 203347607

NAIC Classification: 339110

Form 5500 Filing Information

Submission information for form 5500 for 401k plan AVASURE MEDICAL PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2020-01-01 JACOB LEE 2021-07-15
501 2020-01-01 JACOB LEE 2021-07-15
501 2019-01-01 JACOB LEE 2021-07-15
501 2018-01-01 JACOB LEE 2021-07-15

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
501	2020-01-01	JACOB LEE	2021-07-15
501	2020-01-01	JACOB LEE	2021-07-15
501	2019-01-01	JACOB LEE	2021-07-15
501	2018-01-01	JACOB LEE	2021-07-15

Plan Statistics for AVASURE MEDICAL PLAN

401k plan membership statisitcs for AVASURE MEDICAL PLAN

Measure Date Value
2020: AVASURE MEDICAL PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 114
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 0
Number of retired or separated participants receiving benefits 2020-01-01 0
Number of other retired or separated participants entitled to future benefits 2020-01-01 0
Total of all active and inactive participants 2020-01-01 0
Number of employers contributing to the scheme 2020-01-01 0
2019: AVASURE MEDICAL PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 107
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 113
Number of retired or separated participants receiving benefits 2019-01-01 0
Number of other retired or separated participants entitled to future benefits 2019-01-01 0
Total of all active and inactive participants 2019-01-01 113
Number of employers contributing to the scheme 2019-01-01 0
2018: AVASURE MEDICAL PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 107
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 113
Number of retired or separated participants receiving benefits 2018-01-01 0
Number of other retired or separated participants entitled to future benefits 2018-01-01 0
Total of all active and inactive participants 2018-01-01 113
Number of employers contributing to the scheme 2018-01-01 0

Measure	Date	Value
2020: AVASURE MEDICAL PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	114
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	0
Number of retired or separated participants receiving benefits	2020-01-01	0
Number of other retired or separated participants entitled to future benefits	2020-01-01	0
Total of all active and inactive participants	2020-01-01	0
Number of employers contributing to the scheme	2020-01-01	0
2019: AVASURE MEDICAL PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	107
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	113
Number of retired or separated participants receiving benefits	2019-01-01	0
Number of other retired or separated participants entitled to future benefits	2019-01-01	0
Total of all active and inactive participants	2019-01-01	113
Number of employers contributing to the scheme	2019-01-01	0
2018: AVASURE MEDICAL PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	107
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	113
Number of retired or separated participants receiving benefits	2018-01-01	0
Number of other retired or separated participants entitled to future benefits	2018-01-01	0
Total of all active and inactive participants	2018-01-01	113
Number of employers contributing to the scheme	2018-01-01	0

Form 5500 Responses for AVASURE MEDICAL PLAN

2020: AVASURE MEDICAL PLAN 2020 form 5500 responses
2020-01-01	Type of plan entity	Single employer plan
2020-01-01	This submission is the final filing	Yes
2020-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2020-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2019: AVASURE MEDICAL PLAN 2019 form 5500 responses
2019-01-01	Type of plan entity	Single employer plan
2019-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2019-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2018: AVASURE MEDICAL PLAN 2018 form 5500 responses
2018-01-01	Type of plan entity	Single employer plan
2018-01-01	First time form 5500 has been submitted	Yes
2018-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2018-01-01	Plan benefit arrangement – General assets of the sponsor	Yes

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Company Name:	AVASURE OPCO HOLDINGS, LLC
Employer identification number (EIN):	203347607
NAIC Classification:	339110