UNIVERSAL PEDIATRIC SERVICES - HEALTH PLAN 401k Plan overview
| Plan Name | UNIVERSAL PEDIATRIC SERVICES - HEALTH PLAN |
| Plan identification number | 503 |
UNIVERSAL PEDIATRIC SERVICES - HEALTH PLAN Benefits
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits | - Health (other than dental or vision)
- Other welfare benefit cover
|
401k Sponsoring company profile
UNIVERSAL PEDIATRIC SERVICES, INC. has sponsored the creation of one or more 401k plans.
Additional information about UNIVERSAL PEDIATRIC SERVICES, INC.
| Jurisdiction of Incorporation: | Iowa Secretary of State Business Entities |
| Incorporation Date: | 1985-05-21 |
| Company Identification Number: | 102320 |
| Legal Registered Office Address: |
700 WALNUT STREET
SUITE 1600
DES MOINES
United States of America (USA)
50309
|
More information about UNIVERSAL PEDIATRIC SERVICES, INC.
Form 5500 Filing Information
Submission information for form 5500 for 401k plan UNIVERSAL PEDIATRIC SERVICES - HEALTH PLAN
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|
| 503 | 2022-01-01 | STEVEN TUCKER ANDERSON | 2023-06-23 | | |
| 503 | 2021-01-01 | STEVEN TUCKER ANDERSON | 2022-05-20 | | |
| 503 | 2020-08-01 | STEVEN TUCKER ANDERSON | 2021-08-24 | | |
Plan Statistics for UNIVERSAL PEDIATRIC SERVICES - HEALTH PLAN
401k plan membership statisitcs for UNIVERSAL PEDIATRIC SERVICES - HEALTH PLAN
| Measure | Date | Value |
|---|
| 2022: UNIVERSAL PEDIATRIC SERVICES - HEALTH PLAN 2022 401k membership |
|---|
| Total participants, beginning-of-year | 2022-01-01 | 90 |
| Total number of active participants reported on line 7a of the Form 5500 | 2022-01-01 | 73 |
| Number of retired or separated participants receiving benefits | 2022-01-01 | 0 |
| Total of all active and inactive participants | 2022-01-01 | 73 |
| 2021: UNIVERSAL PEDIATRIC SERVICES - HEALTH PLAN 2021 401k membership |
|---|
| Total participants, beginning-of-year | 2021-01-01 | 108 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-01-01 | 80 |
| Number of retired or separated participants receiving benefits | 2021-01-01 | 1 |
| Total of all active and inactive participants | 2021-01-01 | 81 |
| 2020: UNIVERSAL PEDIATRIC SERVICES - HEALTH PLAN 2020 401k membership |
|---|
| Total participants, beginning-of-year | 2020-08-01 | 112 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-08-01 | 107 |
| Number of retired or separated participants receiving benefits | 2020-08-01 | 3 |
| Total of all active and inactive participants | 2020-08-01 | 110 |
Form 5500 Responses for UNIVERSAL PEDIATRIC SERVICES - HEALTH PLAN
| 2022: UNIVERSAL PEDIATRIC SERVICES - HEALTH PLAN 2022 form 5500 responses |
|---|
| 2022-01-01 | Type of plan entity | Single employer plan |
| 2022-01-01 | Plan funding arrangement – Insurance | Yes |
| 2022-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2022-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2021: UNIVERSAL PEDIATRIC SERVICES - HEALTH PLAN 2021 form 5500 responses |
|---|
| 2021-01-01 | Type of plan entity | Single employer plan |
| 2021-01-01 | Plan funding arrangement – Insurance | Yes |
| 2021-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2021-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2020: UNIVERSAL PEDIATRIC SERVICES - HEALTH PLAN 2020 form 5500 responses |
|---|
| 2020-08-01 | Type of plan entity | Single employer plan |
| 2020-08-01 | First time form 5500 has been submitted | Yes |
| 2020-08-01 | This return/report is a short plan year return/report (less than 12 months) | Yes |
| 2020-08-01 | Plan funding arrangement – Insurance | Yes |
| 2020-08-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2020-08-01 | Plan benefit arrangement – Insurance | Yes |
Insurance Providers Used on plan
| WELLMARK BLUE CROSS BLUE SHIELD OF SOUTH DAKOTA (National Association of Insurance Commissioners NAIC id number: 88848 ) |
| Policy contract number | B27 |
| Policy instance | 1 |
| Insurance contract or identification number | B27 | | Number of Individuals Covered | 73 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $29,940 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $29,940 | | Insurance broker organization code? | 3 |
|
| WELLMARK BLUE CROSS BLUE SHIELD OF SOUTH DAKOTA (National Association of Insurance Commissioners NAIC id number: 88848 ) |
| Policy contract number | B27 |
| Policy instance | 1 |
| Insurance contract or identification number | B27 | | Number of Individuals Covered | 80 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $32,340 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $32,340 | | Insurance broker organization code? | 3 |
|
| WELLMARK BLUE CROSS BLUE SHIELD OF SOUTH DAKOTA (National Association of Insurance Commissioners NAIC id number: 88848 ) |
| Policy contract number | B27 |
| Policy instance | 1 |
| Insurance contract or identification number | B27 | | Number of Individuals Covered | 107 | | Insurance policy start date | 2020-08-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $16,350 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $16,350 | | Insurance broker organization code? | 3 |
|
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