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| Plan Name | ALLIED PEDIATRICS OF NEW YORK PLLC HEALTH PLAN |
| Plan identification number | 501 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | ALLIED PHYSICIANS GROUP PLLC |
| Employer identification number (EIN): | 204762421 |
| 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 |
|---|---|---|---|---|---|
| 501 | 2012-08-01 | SHERYL BLUMBERG | SHERYL BLUMBERG | 2014-02-26 | |
| 501 | 2012-08-01 | MEGAN MILLEVOY | 2020-03-11 |
| Measure | Date | Value |
|---|---|---|
| 2012: ALLIED PEDIATRICS OF NEW YORK PLLC HEALTH PLAN 2012 401k membership | ||
| Total participants, beginning-of-year | 2012-08-01 | 102 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-08-01 | 99 |
| Number of retired or separated participants receiving benefits | 2012-08-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2012-08-01 | 0 |
| Total of all active and inactive participants | 2012-08-01 | 99 |
| Number of employers contributing to the scheme | 2012-08-01 | 0 |
| 2012: ALLIED PEDIATRICS OF NEW YORK PLLC HEALTH PLAN 2012 form 5500 responses | ||
|---|---|---|
| 2012-08-01 | Type of plan entity | Single employer plan |
| 2012-08-01 | First time form 5500 has been submitted | Yes |
| 2012-08-01 | Submission has been amended | No |
| 2012-08-01 | This submission is the final filing | No |
| 2012-08-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2012-08-01 | Plan is a collectively bargained plan | No |
| 2012-08-01 | Plan funding arrangement – Insurance | Yes |
| 2012-08-01 | Plan benefit arrangement – Insurance | Yes |
| MVP HEALTH CARE (National Association of Insurance Commissioners NAIC id number: 95521 ) | |||||||||||||||||||||||||
| Policy contract number | 404402 | ||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||
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| OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 ) | |||||||||||||||||||||||||
| Policy contract number | AP25086 | ||||||||||||||||||||||||
| Policy instance | 2 | ||||||||||||||||||||||||
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