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| Plan Name | ROCKFORD GASTROENTEROLOGY ASSOCIATES, LTD HEALTH AND DENTAL PLAN |
| Plan identification number | 501 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | ROCKFORD GASTROENTEROLOGY ASSOCIATES, LTD. |
| Employer identification number (EIN): | 363081482 |
| 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 | 2022-09-01 | ||||
| 501 | 2021-09-01 | CRYSTAL LARSON | 2023-03-06 | ||
| 501 | 2018-09-01 | ||||
| 501 | 2016-09-01 | KATHY WERSCHIN |
| Measure | Date | Value |
|---|---|---|
| 2022: ROCKFORD GASTROENTEROLOGY ASSOCIATES, LTD HEALTH AND DENTAL PLAN 2022 401k membership | ||
| Total participants, beginning-of-year | 2022-09-01 | 103 |
| Total number of active participants reported on line 7a of the Form 5500 | 2022-09-01 | 107 |
| Number of retired or separated participants receiving benefits | 2022-09-01 | 1 |
| Number of other retired or separated participants entitled to future benefits | 2022-09-01 | 0 |
| Total of all active and inactive participants | 2022-09-01 | 108 |
| 2021: ROCKFORD GASTROENTEROLOGY ASSOCIATES, LTD HEALTH AND DENTAL PLAN 2021 401k membership | ||
| Total participants, beginning-of-year | 2021-09-01 | 107 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-09-01 | 107 |
| Number of retired or separated participants receiving benefits | 2021-09-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2021-09-01 | 0 |
| Total of all active and inactive participants | 2021-09-01 | 107 |
| 2018: ROCKFORD GASTROENTEROLOGY ASSOCIATES, LTD HEALTH AND DENTAL PLAN 2018 401k membership | ||
| Total participants, beginning-of-year | 2018-09-01 | 104 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-09-01 | 96 |
| Total of all active and inactive participants | 2018-09-01 | 96 |
| 2016: ROCKFORD GASTROENTEROLOGY ASSOCIATES, LTD HEALTH AND DENTAL PLAN 2016 401k membership | ||
| Total participants, beginning-of-year | 2016-09-01 | 102 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-09-01 | 99 |
| Total of all active and inactive participants | 2016-09-01 | 99 |
| 2022: ROCKFORD GASTROENTEROLOGY ASSOCIATES, LTD HEALTH AND DENTAL PLAN 2022 form 5500 responses | ||
|---|---|---|
| 2022-09-01 | Type of plan entity | Single employer plan |
| 2022-09-01 | Submission has been amended | No |
| 2022-09-01 | This submission is the final filing | No |
| 2022-09-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2022-09-01 | Plan is a collectively bargained plan | No |
| 2022-09-01 | Plan funding arrangement – Insurance | Yes |
| 2022-09-01 | Plan benefit arrangement – Insurance | Yes |
| 2021: ROCKFORD GASTROENTEROLOGY ASSOCIATES, LTD HEALTH AND DENTAL PLAN 2021 form 5500 responses | ||
| 2021-09-01 | Type of plan entity | Single employer plan |
| 2021-09-01 | Submission has been amended | No |
| 2021-09-01 | This submission is the final filing | No |
| 2021-09-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2021-09-01 | Plan is a collectively bargained plan | No |
| 2021-09-01 | Plan funding arrangement – Insurance | Yes |
| 2021-09-01 | Plan benefit arrangement – Insurance | Yes |
| 2018: ROCKFORD GASTROENTEROLOGY ASSOCIATES, LTD HEALTH AND DENTAL PLAN 2018 form 5500 responses | ||
| 2018-09-01 | Type of plan entity | Single employer plan |
| 2018-09-01 | Submission has been amended | No |
| 2018-09-01 | This submission is the final filing | No |
| 2018-09-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2018-09-01 | Plan is a collectively bargained plan | No |
| 2018-09-01 | Plan funding arrangement – Insurance | Yes |
| 2018-09-01 | Plan benefit arrangement – Insurance | Yes |
| 2016: ROCKFORD GASTROENTEROLOGY ASSOCIATES, LTD HEALTH AND DENTAL PLAN 2016 form 5500 responses | ||
| 2016-09-01 | Type of plan entity | Single employer plan |
| 2016-09-01 | First time form 5500 has been submitted | Yes |
| 2016-09-01 | Submission has been amended | No |
| 2016-09-01 | This submission is the final filing | No |
| 2016-09-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2016-09-01 | Plan is a collectively bargained plan | No |
| 2016-09-01 | Plan funding arrangement – Insurance | Yes |
| 2016-09-01 | Plan benefit arrangement – Insurance | Yes |
| BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | 860149 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | 860150 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | 860150 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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