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ILLINOIS RETINA ASSOCIATES SC EMPLOYEE BENEFIT PLAN 401k Plan overview

Plan NameILLINOIS RETINA ASSOCIATES SC EMPLOYEE BENEFIT PLAN
Plan identification number 501

ILLINOIS RETINA ASSOCIATES SC EMPLOYEE BENEFIT PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Vision
  • Long-term disability cover

401k Sponsoring company profile

ILLINOIS RETINA ASSOCIATES, S.C. has sponsored the creation of one or more 401k plans.

Company Name:ILLINOIS RETINA ASSOCIATES, S.C.
Employer identification number (EIN):362970624
NAIC Classification:812990
NAIC Description:All Other Personal Services

Form 5500 Filing Information

Submission information for form 5500 for 401k plan ILLINOIS RETINA ASSOCIATES SC EMPLOYEE BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012020-12-01
5012019-12-01
5012018-12-01
5012017-12-01
5012016-12-01DAVID ORTH
5012015-12-01DAVID ORTH
5012015-01-01DAVID ORTH
5012015-01-01 DAVID ORTH
5012014-12-01DAVID ORTH

Plan Statistics for ILLINOIS RETINA ASSOCIATES SC EMPLOYEE BENEFIT PLAN

401k plan membership statisitcs for ILLINOIS RETINA ASSOCIATES SC EMPLOYEE BENEFIT PLAN

Measure Date Value
2020: ILLINOIS RETINA ASSOCIATES SC EMPLOYEE BENEFIT PLAN 2020 401k membership
Total participants, beginning-of-year2020-12-01134
Total number of active participants reported on line 7a of the Form 55002020-12-01141
Number of retired or separated participants receiving benefits2020-12-010
Number of other retired or separated participants entitled to future benefits2020-12-010
Total of all active and inactive participants2020-12-01141
2019: ILLINOIS RETINA ASSOCIATES SC EMPLOYEE BENEFIT PLAN 2019 401k membership
Total participants, beginning-of-year2019-12-01135
Total number of active participants reported on line 7a of the Form 55002019-12-01134
Number of retired or separated participants receiving benefits2019-12-010
Number of other retired or separated participants entitled to future benefits2019-12-010
Total of all active and inactive participants2019-12-01134
2018: ILLINOIS RETINA ASSOCIATES SC EMPLOYEE BENEFIT PLAN 2018 401k membership
Total participants, beginning-of-year2018-12-01135
Total number of active participants reported on line 7a of the Form 55002018-12-01137
Number of retired or separated participants receiving benefits2018-12-010
Number of other retired or separated participants entitled to future benefits2018-12-010
Total of all active and inactive participants2018-12-01137
2017: ILLINOIS RETINA ASSOCIATES SC EMPLOYEE BENEFIT PLAN 2017 401k membership
Total participants, beginning-of-year2017-12-010
Total number of active participants reported on line 7a of the Form 55002017-12-010
Number of retired or separated participants receiving benefits2017-12-010
Number of other retired or separated participants entitled to future benefits2017-12-010
Total of all active and inactive participants2017-12-010
2016: ILLINOIS RETINA ASSOCIATES SC EMPLOYEE BENEFIT PLAN 2016 401k membership
Total participants, beginning-of-year2016-12-010
Total number of active participants reported on line 7a of the Form 55002016-12-010
Number of retired or separated participants receiving benefits2016-12-010
Number of other retired or separated participants entitled to future benefits2016-12-010
Total of all active and inactive participants2016-12-010
2015: ILLINOIS RETINA ASSOCIATES SC EMPLOYEE BENEFIT PLAN 2015 401k membership
Total participants, beginning-of-year2015-12-010
Total number of active participants reported on line 7a of the Form 55002015-12-010
Number of retired or separated participants receiving benefits2015-12-010
Number of other retired or separated participants entitled to future benefits2015-12-010
Total of all active and inactive participants2015-12-010
Total participants, beginning-of-year2015-01-010
Total number of active participants reported on line 7a of the Form 55002015-01-010
Number of retired or separated participants receiving benefits2015-01-010
Number of other retired or separated participants entitled to future benefits2015-01-010
Total of all active and inactive participants2015-01-010
2014: ILLINOIS RETINA ASSOCIATES SC EMPLOYEE BENEFIT PLAN 2014 401k membership
Total participants, beginning-of-year2014-12-010
Total number of active participants reported on line 7a of the Form 55002014-12-010
Number of retired or separated participants receiving benefits2014-12-010
Number of other retired or separated participants entitled to future benefits2014-12-010
Total of all active and inactive participants2014-12-010

Financial Data on ILLINOIS RETINA ASSOCIATES SC EMPLOYEE BENEFIT PLAN

Measure Date Value
2015 : ILLINOIS RETINA ASSOCIATES SC EMPLOYEE BENEFIT PLAN 2015 401k financial data
Total income from all sources2015-11-30$0
Total plan assets at end of year2015-11-30$0
Total plan assets at beginning of year2015-11-30$0
Net plan assets at end of year (total assets less liabilities)2015-11-30$0
Net plan assets at beginning of year (total assets less liabilities)2015-11-30$0

Form 5500 Responses for ILLINOIS RETINA ASSOCIATES SC EMPLOYEE BENEFIT PLAN

2020: ILLINOIS RETINA ASSOCIATES SC EMPLOYEE BENEFIT PLAN 2020 form 5500 responses
2020-12-01Type of plan entitySingle employer plan
2020-12-01Plan funding arrangement – InsuranceYes
2020-12-01Plan benefit arrangement – InsuranceYes
2019: ILLINOIS RETINA ASSOCIATES SC EMPLOYEE BENEFIT PLAN 2019 form 5500 responses
2019-12-01Type of plan entitySingle employer plan
2019-12-01Plan funding arrangement – InsuranceYes
2019-12-01Plan benefit arrangement – InsuranceYes
2018: ILLINOIS RETINA ASSOCIATES SC EMPLOYEE BENEFIT PLAN 2018 form 5500 responses
2018-12-01Type of plan entitySingle employer plan
2018-12-01Plan funding arrangement – InsuranceYes
2018-12-01Plan benefit arrangement – InsuranceYes
2017: ILLINOIS RETINA ASSOCIATES SC EMPLOYEE BENEFIT PLAN 2017 form 5500 responses
2017-12-01Type of plan entitySingle employer plan
2017-12-01Plan funding arrangement – InsuranceYes
2017-12-01Plan benefit arrangement – InsuranceYes
2016: ILLINOIS RETINA ASSOCIATES SC EMPLOYEE BENEFIT PLAN 2016 form 5500 responses
2016-12-01Type of plan entitySingle employer plan
2016-12-01Plan funding arrangement – InsuranceYes
2016-12-01Plan benefit arrangement – InsuranceYes
2015: ILLINOIS RETINA ASSOCIATES SC EMPLOYEE BENEFIT PLAN 2015 form 5500 responses
2015-12-01Type of plan entitySingle employer plan
2015-12-01Plan funding arrangement – InsuranceYes
2015-12-01Plan benefit arrangement – InsuranceYes
2015-01-01Type of plan entitySingle employer plan
2015-01-01First time form 5500 has been submittedYes
2015-01-01Submission has been amendedYes
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan benefit arrangement – InsuranceYes
2014: ILLINOIS RETINA ASSOCIATES SC EMPLOYEE BENEFIT PLAN 2014 form 5500 responses
2014-12-01Type of plan entitySingle employer plan
2014-12-01First time form 5500 has been submittedYes
2014-12-01Submission has been amendedYes
2014-12-01Plan funding arrangement – InsuranceYes
2014-12-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )
Policy contract numberB10199 P10199 P
Policy instance 1
Insurance contract or identification numberB10199 P10199 P
Number of Individuals Covered141
Insurance policy start date2020-12-01
Insurance policy end date2021-11-30
Total amount of commissions paid to insurance brokerUSD $52,654
Total amount of fees paid to insurance companyUSD $2,425
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,331,047
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $52,654
Amount paid for insurance broker fees2425
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00269713
Policy instance 2
Insurance contract or identification number00269713
Number of Individuals Covered110
Insurance policy start date2020-12-01
Insurance policy end date2021-11-30
Total amount of commissions paid to insurance brokerUSD $5,544
Total amount of fees paid to insurance companyUSD $1,436
Welfare Benefit Premiums Paid to CarrierUSD $75,033
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,544
Amount paid for insurance broker fees1436
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )
Policy contract numberB10199 P10199 P
Policy instance 1
Insurance contract or identification numberB10199 P10199 P
Number of Individuals Covered134
Insurance policy start date2019-12-01
Insurance policy end date2020-11-30
Total amount of commissions paid to insurance brokerUSD $49,297
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,271,888
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00269713
Policy instance 2
Insurance contract or identification number00269713
Number of Individuals Covered97
Insurance policy start date2019-12-01
Insurance policy end date2020-11-30
Total amount of commissions paid to insurance brokerUSD $5,112
Total amount of fees paid to insurance companyUSD $1,121
Welfare Benefit Premiums Paid to CarrierUSD $69,064
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )
Policy contract numberB10199 P10199 P
Policy instance 1
Insurance contract or identification numberB10199 P10199 P
Number of Individuals Covered137
Insurance policy start date2018-12-01
Insurance policy end date2019-11-30
Total amount of commissions paid to insurance brokerUSD $45,394
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,146,001
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $45,394
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00269713
Policy instance 2
Insurance contract or identification number00269713
Number of Individuals Covered95
Insurance policy start date2018-12-01
Insurance policy end date2019-11-30
Total amount of commissions paid to insurance brokerUSD $5,888
Total amount of fees paid to insurance companyUSD $180
Welfare Benefit Premiums Paid to CarrierUSD $75,633
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,888
Amount paid for insurance broker fees180
Additional information about fees paid to insurance brokerADMINISTRATIVE FEE
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )
Policy contract numberB10199 P10199 P
Policy instance 1
Insurance contract or identification numberB10199 P10199 P
Number of Individuals Covered135
Insurance policy start date2017-12-01
Insurance policy end date2018-11-30
Total amount of commissions paid to insurance brokerUSD $43,334
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,112,795
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00269713
Policy instance 2
Insurance contract or identification number00269713
Number of Individuals Covered95
Insurance policy start date2017-12-01
Insurance policy end date2018-11-30
Total amount of commissions paid to insurance brokerUSD $4,494
Total amount of fees paid to insurance companyUSD $1,011
Welfare Benefit Premiums Paid to CarrierUSD $60,661
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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