MAYFIELD CLINIC, INC. HEALTH AND WELFARE BENEFITPLAN 401k Plan overview
| Plan Name | MAYFIELD CLINIC, INC. HEALTH AND WELFARE BENEFITPLAN |
| Plan identification number | 501 |
MAYFIELD CLINIC, INC. HEALTH AND WELFARE BENEFITPLAN Benefits
| 401k Plan Type | Welfare 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
MAYFIELD CLINIC, INC. has sponsored the creation of one or more 401k plans.
| Company Name: | MAYFIELD CLINIC, INC. |
| Employer identification number (EIN): | 310588183 |
| NAIC Classification: | 621111 |
| NAIC Description: | Offices of Physicians (except Mental Health Specialists) |
Additional information about MAYFIELD CLINIC, INC.
| Jurisdiction of Incorporation: | Ohio Secretary of State Business Services Division |
| Incorporation Date: | 1970-06-24 |
| Company Identification Number: | 399028 |
| Legal Registered Office Address: |
425 WALNUT ST #1800
-
CINCINNATI
United States of America (USA)
452020000
|
More information about MAYFIELD CLINIC, INC.
Form 5500 Filing Information
Submission information for form 5500 for 401k plan MAYFIELD CLINIC, INC. HEALTH AND WELFARE BENEFITPLAN
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|
| 501 | 2023-01-01 | LORI GULLEY | 2024-06-11 | | |
Plan Statistics for MAYFIELD CLINIC, INC. HEALTH AND WELFARE BENEFITPLAN
401k plan membership statisitcs for MAYFIELD CLINIC, INC. HEALTH AND WELFARE BENEFITPLAN
| Measure | Date | Value |
|---|
| 2023: MAYFIELD CLINIC, INC. HEALTH AND WELFARE BENEFITPLAN 2023 401k membership |
|---|
| Total participants, beginning-of-year | 2023-01-01 | 181 |
| Total number of active participants reported on line 7a of the Form 5500 | 2023-01-01 | 166 |
| Number of retired or separated participants receiving benefits | 2023-01-01 | 0 |
| 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 | 166 |
| Number of employers contributing to the scheme | 2023-01-01 | 0 |
Form 5500 Responses for MAYFIELD CLINIC, INC. HEALTH AND WELFARE BENEFITPLAN
| 2023: MAYFIELD CLINIC, INC. HEALTH AND WELFARE BENEFITPLAN 2023 form 5500 responses |
|---|
| 2023-01-01 | Type of plan entity | Single employer plan |
| 2023-01-01 | First time form 5500 has been submitted | Yes |
| 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 |
Insurance Providers Used on plan
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | SOK0608525 |
| Policy instance | 3 |
| Insurance contract or identification number | SOK0608525 | | Number of Individuals Covered | 166 | | Insurance policy start date | 2023-01-01 | | Insurance policy end date | 2023-12-31 | | Total amount of commissions paid to insurance broker | USD $12,155 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | Yes | | Unemployment Insurance Welfare Benefit | No | | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $142,725 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes |
|
| SUPERIOR DENTAL CARE, INC. (National Association of Insurance Commissioners NAIC id number: 96280 ) |
| Policy contract number | D9350, D9325 |
| Policy instance | 1 |
| Insurance contract or identification number | D9350, D9325 | | Number of Individuals Covered | 187 | | Insurance policy start date | 2023-01-01 | | Insurance policy end date | 2023-12-31 | | Total amount of commissions paid to insurance broker | USD $6,434 | | Total amount of fees paid to insurance company | USD $2,677 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
| Policy contract number | 10198011001 |
| Policy instance | 2 |
| Insurance contract or identification number | 10198011001 | | Number of Individuals Covered | 390 | | Insurance policy start date | 2023-01-01 | | Insurance policy end date | 2023-12-31 | | Total amount of commissions paid to insurance broker | USD $2,113 | | Total amount of fees paid to insurance company | USD $0 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $19,293 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
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