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ARIZONA OBGYN AFFILIATES PC HEALTH AND WELFARE PLAN 401k Plan overview

Plan NameARIZONA OBGYN AFFILIATES PC HEALTH AND WELFARE PLAN
Plan identification number 501

ARIZONA OBGYN AFFILIATES PC HEALTH AND WELFARE PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Temporary disability (accident and sickness)
  • Long-term disability cover
  • Death benefits (include travel accident but not life insurance)
  • Other welfare benefit cover

401k Sponsoring company profile

ARIZONA OBGYN AFFILIATES PC has sponsored the creation of one or more 401k plans.

Company Name:ARIZONA OBGYN AFFILIATES PC
Employer identification number (EIN):205198811
NAIC Classification:621111
NAIC Description:Offices of Physicians (except Mental Health Specialists)

Form 5500 Filing Information

Submission information for form 5500 for 401k plan ARIZONA OBGYN AFFILIATES PC HEALTH AND WELFARE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012017-04-01
5012016-04-01PAUL PLATZMAN PAUL PLATZMAN2017-10-16
5012015-04-01PAUL PLATZMAN PAUL PLATZMAN2016-10-10
5012014-04-01PAUL PLATZMAN PAUL PLATZMAN2015-10-08
5012013-04-01PAUL PLATZMAN PAUL PLATZMAN2014-09-23
5012012-04-01PAUL PLATZMAN PAUL PLATZMAN2013-10-15

Plan Statistics for ARIZONA OBGYN AFFILIATES PC HEALTH AND WELFARE PLAN

401k plan membership statisitcs for ARIZONA OBGYN AFFILIATES PC HEALTH AND WELFARE PLAN

Measure Date Value
2017: ARIZONA OBGYN AFFILIATES PC HEALTH AND WELFARE PLAN 2017 401k membership
Total participants, beginning-of-year2017-04-01148
Total number of active participants reported on line 7a of the Form 55002017-04-01148
Number of retired or separated participants receiving benefits2017-04-012
Number of other retired or separated participants entitled to future benefits2017-04-010
Total of all active and inactive participants2017-04-01150
2016: ARIZONA OBGYN AFFILIATES PC HEALTH AND WELFARE PLAN 2016 401k membership
Total participants, beginning-of-year2016-04-01321
Total number of active participants reported on line 7a of the Form 55002016-04-01223
Total of all active and inactive participants2016-04-01223
2015: ARIZONA OBGYN AFFILIATES PC HEALTH AND WELFARE PLAN 2015 401k membership
Total participants, beginning-of-year2015-04-01321
Total number of active participants reported on line 7a of the Form 55002015-04-01223
Total of all active and inactive participants2015-04-01223
2014: ARIZONA OBGYN AFFILIATES PC HEALTH AND WELFARE PLAN 2014 401k membership
Total participants, beginning-of-year2014-04-01152
Total number of active participants reported on line 7a of the Form 55002014-04-01221
Total of all active and inactive participants2014-04-01221
2013: ARIZONA OBGYN AFFILIATES PC HEALTH AND WELFARE PLAN 2013 401k membership
Total participants, beginning-of-year2013-04-01189
Total number of active participants reported on line 7a of the Form 55002013-04-01183
Total of all active and inactive participants2013-04-01183
2012: ARIZONA OBGYN AFFILIATES PC HEALTH AND WELFARE PLAN 2012 401k membership
Total participants, beginning-of-year2012-04-01169
Total number of active participants reported on line 7a of the Form 55002012-04-01169
Number of retired or separated participants receiving benefits2012-04-011
Total of all active and inactive participants2012-04-01170

Form 5500 Responses for ARIZONA OBGYN AFFILIATES PC HEALTH AND WELFARE PLAN

2017: ARIZONA OBGYN AFFILIATES PC HEALTH AND WELFARE PLAN 2017 form 5500 responses
2017-04-01Type of plan entitySingle employer plan
2017-04-01Plan funding arrangement – InsuranceYes
2017-04-01Plan funding arrangement – General assets of the sponsorYes
2017-04-01Plan benefit arrangement – InsuranceYes
2017-04-01Plan benefit arrangement – General assets of the sponsorYes
2016: ARIZONA OBGYN AFFILIATES PC HEALTH AND WELFARE PLAN 2016 form 5500 responses
2016-04-01Type of plan entitySingle employer plan
2016-04-01Submission has been amendedNo
2016-04-01This submission is the final filingNo
2016-04-01This return/report is a short plan year return/report (less than 12 months)No
2016-04-01Plan is a collectively bargained planNo
2016-04-01Plan funding arrangement – InsuranceYes
2016-04-01Plan benefit arrangement – InsuranceYes
2015: ARIZONA OBGYN AFFILIATES PC HEALTH AND WELFARE PLAN 2015 form 5500 responses
2015-04-01Type of plan entitySingle employer plan
2015-04-01Submission has been amendedNo
2015-04-01This submission is the final filingNo
2015-04-01This return/report is a short plan year return/report (less than 12 months)No
2015-04-01Plan is a collectively bargained planNo
2015-04-01Plan funding arrangement – InsuranceYes
2015-04-01Plan benefit arrangement – InsuranceYes
2014: ARIZONA OBGYN AFFILIATES PC HEALTH AND WELFARE PLAN 2014 form 5500 responses
2014-04-01Type of plan entitySingle employer plan
2014-04-01Submission has been amendedNo
2014-04-01This submission is the final filingNo
2014-04-01This return/report is a short plan year return/report (less than 12 months)No
2014-04-01Plan is a collectively bargained planNo
2014-04-01Plan funding arrangement – InsuranceYes
2014-04-01Plan benefit arrangement – InsuranceYes
2013: ARIZONA OBGYN AFFILIATES PC HEALTH AND WELFARE PLAN 2013 form 5500 responses
2013-04-01Type of plan entitySingle employer plan
2013-04-01Submission has been amendedNo
2013-04-01This submission is the final filingNo
2013-04-01This return/report is a short plan year return/report (less than 12 months)No
2013-04-01Plan is a collectively bargained planNo
2013-04-01Plan funding arrangement – InsuranceYes
2013-04-01Plan benefit arrangement – InsuranceYes
2012: ARIZONA OBGYN AFFILIATES PC HEALTH AND WELFARE PLAN 2012 form 5500 responses
2012-04-01Type of plan entitySingle employer plan
2012-04-01First time form 5500 has been submittedYes
2012-04-01Submission has been amendedNo
2012-04-01This submission is the final filingNo
2012-04-01This return/report is a short plan year return/report (less than 12 months)No
2012-04-01Plan is a collectively bargained planNo
2012-04-01Plan funding arrangement – InsuranceYes
2012-04-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberVDT601743
Policy instance 3
Insurance contract or identification numberVDT601743
Number of Individuals Covered148
Insurance policy start date2017-04-01
Insurance policy end date2018-03-31
Total amount of commissions paid to insurance brokerUSD $5,922
Total amount of fees paid to insurance companyUSD $5,429
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $59,217
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $5,922
Amount paid for insurance broker fees2855
Additional information about fees paid to insurance brokerOVERRIDE
Insurance broker organization code?3
Insurance broker nameLIAZON CORPORATION
CIGNA HEALTH AND LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 47013 )
Policy contract number0608986
Policy instance 2
Insurance contract or identification number0608986
Number of Individuals Covered4
Insurance policy start date2017-04-01
Insurance policy end date2018-03-31
Total amount of commissions paid to insurance brokerUSD $1,386
Total amount of fees paid to insurance companyUSD $693
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $13,861
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,386
Amount paid for insurance broker fees0
Insurance broker organization code?3
Insurance broker nameLIAZON BENEFITS INC
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number608986
Policy instance 1
Insurance contract or identification number608986
Number of Individuals Covered148
Insurance policy start date2017-04-01
Insurance policy end date2018-03-31
Total amount of commissions paid to insurance brokerUSD $11,747
Total amount of fees paid to insurance companyUSD $5,874
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $118,373
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $11,747
Amount paid for insurance broker fees0
Insurance broker organization code?3
Additional information about fees paid to insurance brokerSERVICE/GENERAL AGENT PAYMENTS
Insurance broker nameLIAZON BENEFITS INC
UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 )
Policy contract number4052554
Policy instance 2
Insurance contract or identification number4052554
Number of Individuals Covered54
Insurance policy start date2015-04-01
Insurance policy end date2016-03-31
Total amount of commissions paid to insurance brokerUSD $14,517
Total amount of fees paid to insurance companyUSD $0
Temporary Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENT CANCER CRITICAL ILLNESS
Welfare Benefit Premiums Paid to CarrierUSD $49,640
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $14,517
Insurance broker organization code?3
Insurance broker nameLOVITT TOUCHE INC
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number0608986
Policy instance 1
Insurance contract or identification number0608986
Number of Individuals Covered173
Insurance policy start date2015-04-01
Insurance policy end date2016-03-31
Total amount of commissions paid to insurance brokerUSD $44,758
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $441,065
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $44,758
Insurance broker organization code?3
Insurance broker nameLOVITT TOUCHE INC
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberSOK602692
Policy instance 2
Insurance contract or identification numberSOK602692
Number of Individuals Covered221
Insurance policy start date2014-04-01
Insurance policy end date2015-03-31
Total amount of commissions paid to insurance brokerUSD $346
Total amount of fees paid to insurance companyUSD $84
Other welfare benefits providedACCIDENTAL DEATH
Welfare Benefit Premiums Paid to CarrierUSD $3,463
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $346
Amount paid for insurance broker fees84
Additional information about fees paid to insurance brokerOVERRIDE
Insurance broker organization code?3
Insurance broker nameLOVITT TOUCHE INC
UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 )
Policy contract number4052554
Policy instance 3
Insurance contract or identification number4052554
Number of Individuals Covered55
Insurance policy start date2014-04-01
Insurance policy end date2015-03-31
Total amount of commissions paid to insurance brokerUSD $8,004
Total amount of fees paid to insurance companyUSD $0
Temporary Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENT CANCER CRITICAL ILLNESS
Welfare Benefit Premiums Paid to CarrierUSD $42,689
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,004
Insurance broker organization code?3
Insurance broker nameLOVITT TOUCHE INC
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberSGD604102
Policy instance 4
Insurance contract or identification numberSGD604102
Number of Individuals Covered221
Insurance policy start date2014-06-01
Insurance policy end date2015-03-31
Total amount of commissions paid to insurance brokerUSD $346
Total amount of fees paid to insurance companyUSD $0
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,461
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $346
Insurance broker organization code?3
Insurance broker nameLOVITT TOUCHE INC
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberSGM604106
Policy instance 5
Insurance contract or identification numberSGM604106
Number of Individuals Covered221
Insurance policy start date2014-04-01
Insurance policy end date2015-03-31
Total amount of commissions paid to insurance brokerUSD $2,071
Total amount of fees paid to insurance companyUSD $669
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $20,709
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,071
Amount paid for insurance broker fees669
Additional information about fees paid to insurance brokerOVERRIDE
Insurance broker organization code?3
Insurance broker nameLOVITT TOUCHE INC
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number0608986
Policy instance 1
Insurance contract or identification number0608986
Number of Individuals Covered217
Insurance policy start date2014-04-01
Insurance policy end date2015-03-31
Total amount of commissions paid to insurance brokerUSD $10,542
Total amount of fees paid to insurance companyUSD $4,745
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $106,520
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $10,542
Amount paid for insurance broker fees4745
Additional information about fees paid to insurance brokerGENERAL AGENT PAYMENTS
Insurance broker organization code?3
Insurance broker nameLOVITT TOUCHE INC
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberSGM604106
Policy instance 4
Insurance contract or identification numberSGM604106
Number of Individuals Covered112
Insurance policy start date2013-04-01
Insurance policy end date2014-03-31
Total amount of commissions paid to insurance brokerUSD $1,656
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $15,170
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,656
Insurance broker organization code?3
Insurance broker nameLOVITT TOUCHE INC
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number0608986
Policy instance 3
Insurance contract or identification number0608986
Number of Individuals Covered137
Insurance policy start date2013-04-01
Insurance policy end date2014-03-31
Total amount of commissions paid to insurance brokerUSD $6,349
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $64,012
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,349
Insurance broker organization code?3
Insurance broker nameLOVITT TOUCE INC
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberSOK602692
Policy instance 2
Insurance contract or identification numberSOK602692
Number of Individuals Covered112
Insurance policy start date2013-04-01
Insurance policy end date2014-03-31
Total amount of commissions paid to insurance brokerUSD $263
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedACCIDENTAL DEATH
Welfare Benefit Premiums Paid to CarrierUSD $2,629
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $263
Insurance broker organization code?3
Insurance broker nameLOVITT TOUCHE INC
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number00608986
Policy instance 1
Insurance contract or identification number00608986
Number of Individuals Covered150
Insurance policy start date2013-04-01
Insurance policy end date2014-03-31
Total amount of commissions paid to insurance brokerUSD $31,719
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $194,619
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $31,719
Insurance broker organization code?3
Insurance broker nameLOVITT TOUCHE INC
HEALTH NET OF AZ (National Association of Insurance Commissioners NAIC id number: 66141 )
Policy contract numberAC5408
Policy instance 2
Insurance contract or identification numberAC5408
Number of Individuals Covered1
Insurance policy start date2012-04-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $426
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $9,685
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $426
Insurance broker organization code?3
Insurance broker nameM O AGENCIES INC
HEALTH NET OF AZ (National Association of Insurance Commissioners NAIC id number: 66141 )
Policy contract numberAZ5408
Policy instance 3
Insurance contract or identification numberAZ5408
Number of Individuals Covered78
Insurance policy start date2012-04-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $7,726
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $174,469
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,726
Insurance broker organization code?3
Insurance broker nameM O AGENCIES INC
HEALTH NET (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number00000
Policy instance 4
Insurance contract or identification number00000
Number of Individuals Covered107
Insurance policy start date2012-04-01
Insurance policy end date2013-03-31
Total amount of commissions paid to insurance brokerUSD $6,707
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $134,153
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,498
Insurance broker organization code?3
Insurance broker nameM O AGENCIES INC
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number1018186
Policy instance 5
Insurance contract or identification number1018186
Number of Individuals Covered197
Insurance policy start date2012-04-01
Insurance policy end date2013-03-31
Total amount of commissions paid to insurance brokerUSD $1,504
Total amount of fees paid to insurance companyUSD $169
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $15,106
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $226
Insurance broker organization code?3
Amount paid for insurance broker fees169
Additional information about fees paid to insurance brokerBONUS
Insurance broker nameASSURED NL INSURANCE AGENCY INC
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number1018186
Policy instance 6
Insurance contract or identification number1018186
Number of Individuals Covered271
Insurance policy start date2012-04-01
Insurance policy end date2013-03-31
Total amount of commissions paid to insurance brokerUSD $3,385
Total amount of fees paid to insurance companyUSD $798
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $69,558
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $261
Insurance broker organization code?3
Amount paid for insurance broker fees798
Additional information about fees paid to insurance brokerBONUS
Insurance broker nameASSURED NL INSURANCE AGENCY INC
HEALTH NET OF AZ (National Association of Insurance Commissioners NAIC id number: 66141 )
Policy contract numberAZ5407
Policy instance 1
Insurance contract or identification numberAZ5407
Number of Individuals Covered97
Insurance policy start date2012-04-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $9,706
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $217,531
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9,706
Insurance broker organization code?3
Insurance broker nameM O AGENCIES INC

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