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OMNI EYE SPECIALISTS, P.A. SECTION 125 PLAN 401k Plan overview

Plan NameOMNI EYE SPECIALISTS, P.A. SECTION 125 PLAN
Plan identification number 501

OMNI EYE SPECIALISTS, P.A. SECTION 125 PLAN Benefits

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

401k Sponsoring company profile

OMNI EYE SPECIALISTS has sponsored the creation of one or more 401k plans.

Company Name:OMNI EYE SPECIALISTS
Employer identification number (EIN):223587595
NAIC Classification:621320
NAIC Description:Offices of Optometrists

Form 5500 Filing Information

Submission information for form 5500 for 401k plan OMNI EYE SPECIALISTS, P.A. SECTION 125 PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012019-02-01CINDY COBOS2020-08-03
5012018-02-01CHRISTOPHER QUINN2019-11-15
5012017-02-01
5012016-02-01
5012015-02-01
5012015-02-01CINDY COBOS2017-07-03
5012014-08-01CINDY COBOS
5012014-08-01

Plan Statistics for OMNI EYE SPECIALISTS, P.A. SECTION 125 PLAN

401k plan membership statisitcs for OMNI EYE SPECIALISTS, P.A. SECTION 125 PLAN

Measure Date Value
2019: OMNI EYE SPECIALISTS, P.A. SECTION 125 PLAN 2019 401k membership
Total participants, beginning-of-year2019-02-01429
Total number of active participants reported on line 7a of the Form 55002019-02-01375
Number of retired or separated participants receiving benefits2019-02-010
Number of other retired or separated participants entitled to future benefits2019-02-010
Total of all active and inactive participants2019-02-01375
Number of employers contributing to the scheme2019-02-010
2018: OMNI EYE SPECIALISTS, P.A. SECTION 125 PLAN 2018 401k membership
Total participants, beginning-of-year2018-02-01197
Total number of active participants reported on line 7a of the Form 55002018-02-01429
Number of retired or separated participants receiving benefits2018-02-010
Number of other retired or separated participants entitled to future benefits2018-02-010
Total of all active and inactive participants2018-02-01429
2017: OMNI EYE SPECIALISTS, P.A. SECTION 125 PLAN 2017 401k membership
Total participants, beginning-of-year2017-02-01156
Total number of active participants reported on line 7a of the Form 55002017-02-01197
Number of retired or separated participants receiving benefits2017-02-010
Number of other retired or separated participants entitled to future benefits2017-02-010
Total of all active and inactive participants2017-02-01197
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2017-02-010
Total participants2017-02-01197
Number of participants with account balances2017-02-010
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2017-02-010
2016: OMNI EYE SPECIALISTS, P.A. SECTION 125 PLAN 2016 401k membership
Total participants, beginning-of-year2016-02-01133
Total number of active participants reported on line 7a of the Form 55002016-02-01156
Total of all active and inactive participants2016-02-01156
Total participants2016-02-01156
2015: OMNI EYE SPECIALISTS, P.A. SECTION 125 PLAN 2015 401k membership
Total participants, beginning-of-year2015-02-01122
Total number of active participants reported on line 7a of the Form 55002015-02-01133
Total of all active and inactive participants2015-02-01133
Total participants2015-02-01133
2014: OMNI EYE SPECIALISTS, P.A. SECTION 125 PLAN 2014 401k membership
Total participants, beginning-of-year2014-08-01122
Total number of active participants reported on line 7a of the Form 55002014-08-01122
Number of retired or separated participants receiving benefits2014-08-010
Number of other retired or separated participants entitled to future benefits2014-08-010
Total of all active and inactive participants2014-08-01122
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-08-010
Total participants2014-08-01122

Form 5500 Responses for OMNI EYE SPECIALISTS, P.A. SECTION 125 PLAN

2019: OMNI EYE SPECIALISTS, P.A. SECTION 125 PLAN 2019 form 5500 responses
2019-02-01Type of plan entitySingle employer plan
2019-02-01Plan funding arrangement – InsuranceYes
2019-02-01Plan funding arrangement – General assets of the sponsorYes
2019-02-01Plan benefit arrangement – InsuranceYes
2019-02-01Plan benefit arrangement – General assets of the sponsorYes
2018: OMNI EYE SPECIALISTS, P.A. SECTION 125 PLAN 2018 form 5500 responses
2018-02-01Type of plan entitySingle employer plan
2018-02-01Plan funding arrangement – InsuranceYes
2018-02-01Plan benefit arrangement – InsuranceYes
2017: OMNI EYE SPECIALISTS, P.A. SECTION 125 PLAN 2017 form 5500 responses
2017-02-01Type of plan entitySingle employer plan
2017-02-01Plan funding arrangement – InsuranceYes
2017-02-01Plan benefit arrangement – InsuranceYes
2016: OMNI EYE SPECIALISTS, P.A. SECTION 125 PLAN 2016 form 5500 responses
2016-02-01Type of plan entitySingle employer plan
2016-02-01Plan funding arrangement – InsuranceYes
2016-02-01Plan benefit arrangement – InsuranceYes
2015: OMNI EYE SPECIALISTS, P.A. SECTION 125 PLAN 2015 form 5500 responses
2015-02-01Type of plan entitySingle employer plan
2015-02-01Submission has been amendedYes
2015-02-01Plan funding arrangement – InsuranceYes
2015-02-01Plan benefit arrangement – InsuranceYes
2014: OMNI EYE SPECIALISTS, P.A. SECTION 125 PLAN 2014 form 5500 responses
2014-08-01Type of plan entitySingle employer plan
2014-08-01First time form 5500 has been submittedYes
2014-08-01Submission has been amendedYes
2014-08-01This submission is the final filingNo
2014-08-01This return/report is a short plan year return/report (less than 12 months)Yes
2014-08-01Plan is a collectively bargained planNo
2014-08-01Plan funding arrangement – InsuranceYes
2014-08-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number1105580
Policy instance 1
Insurance contract or identification number1105580
Number of Individuals Covered483
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $16,410
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $151,556
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9,063
Amount paid for insurance broker fees0
Insurance broker organization code?3
HORIZON HEALTHCARE SERVICES, INC. (National Association of Insurance Commissioners NAIC id number: 55069 )
Policy contract number851E9
Policy instance 2
Insurance contract or identification number851E9
Number of Individuals Covered248
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $76,279
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Welfare Benefit Premiums Paid to CarrierUSD $2,139,002
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $44,683
Amount paid for insurance broker fees0
Insurance broker organization code?3
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number0764916
Policy instance 1
Insurance contract or identification number0764916
Insurance policy start date2018-02-01
Insurance policy end date2019-01-31
Total amount of commissions paid to insurance brokerUSD $9,149
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $1,393,437
Commission paid to Insurance BrokerUSD $6,923
Insurance broker organization code?3
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number0764916
Policy instance 1
Insurance contract or identification number0764916
Number of Individuals Covered197
Insurance policy start date2017-02-01
Insurance policy end date2018-01-31
Total amount of commissions paid to insurance brokerUSD $39,024
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $773,076
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $39,024
Amount paid for insurance broker fees0
Insurance broker organization code?3
Insurance broker nameLEONARD BRODSKY

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