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CLAY PLATTE FAMILY MEDICINE CLINIC, P.C. GROUP HEALTH PLAN 401k Plan overview

Plan NameCLAY PLATTE FAMILY MEDICINE CLINIC, P.C. GROUP HEALTH PLAN
Plan identification number 502

CLAY PLATTE FAMILY MEDICINE CLINIC, P.C. GROUP HEALTH PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Vision
  • Death benefits (include travel accident but not life insurance)
  • Other welfare benefit cover

401k Sponsoring company profile

CLAY PLATTE FAMILY MEDICINE CLINIC has sponsored the creation of one or more 401k plans.

Company Name:CLAY PLATTE FAMILY MEDICINE CLINIC
Employer identification number (EIN):431702375
NAIC Classification:621111
NAIC Description:Offices of Physicians (except Mental Health Specialists)

Form 5500 Filing Information

Submission information for form 5500 for 401k plan CLAY PLATTE FAMILY MEDICINE CLINIC, P.C. GROUP HEALTH PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5022023-01-01
5022023-01-01SCOTT KUENNEN
5022022-01-01
5022022-01-01SCOTT KUENNEN
5022021-01-01
5022021-01-01SCOTT KUENNEN
5022020-01-01
5022019-01-01
5022018-01-01SCOTT KUENNEN SCOTT KUENNEN2019-05-09
5022017-01-01SCOTT KUENNEN SCOTT KUENNEN2018-07-02
5022016-01-01SCOTT KUENNEN SCOTT KUENNEN2017-06-29
5022015-01-01SCOTT KUENNEN SCOTT KUENNEN2016-07-11
5022014-01-01SCOTT KUENNEN SCOTT KUENNEN2015-08-04

Form 5500 Responses for CLAY PLATTE FAMILY MEDICINE CLINIC, P.C. GROUP HEALTH PLAN

2023: CLAY PLATTE FAMILY MEDICINE CLINIC, P.C. GROUP HEALTH PLAN 2023 form 5500 responses
2023-01-01Type of plan entitySingle employer plan
2023-01-01Plan funding arrangement – InsuranceYes
2023-01-01Plan benefit arrangement – InsuranceYes
2022: CLAY PLATTE FAMILY MEDICINE CLINIC, P.C. GROUP HEALTH PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan benefit arrangement – InsuranceYes
2021: CLAY PLATTE FAMILY MEDICINE CLINIC, P.C. GROUP HEALTH PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan benefit arrangement – InsuranceYes
2020: CLAY PLATTE FAMILY MEDICINE CLINIC, P.C. GROUP HEALTH PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan benefit arrangement – InsuranceYes
2019: CLAY PLATTE FAMILY MEDICINE CLINIC, P.C. GROUP HEALTH PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan benefit arrangement – InsuranceYes
2018: CLAY PLATTE FAMILY MEDICINE CLINIC, P.C. GROUP HEALTH PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan benefit arrangement – InsuranceYes
2017: CLAY PLATTE FAMILY MEDICINE CLINIC, P.C. GROUP HEALTH PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan benefit arrangement – InsuranceYes
2016: CLAY PLATTE FAMILY MEDICINE CLINIC, P.C. GROUP HEALTH PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan benefit arrangement – InsuranceYes
2015: CLAY PLATTE FAMILY MEDICINE CLINIC, P.C. GROUP HEALTH PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan benefit arrangement – InsuranceYes
2014: CLAY PLATTE FAMILY MEDICINE CLINIC, P.C. GROUP HEALTH PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01First time form 5500 has been submittedYes
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number1022781
Policy instance 1
Insurance contract or identification number1022781
Number of Individuals Covered309
Insurance policy start date2022-11-01
Insurance policy end date2023-10-31
Total amount of commissions paid to insurance brokerUSD $9,744
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $160,029
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number1022781
Policy instance 1
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number1022781
Policy instance 1
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number1022781
Policy instance 1
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number1022781
Policy instance 1
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number1022781
Policy instance 1
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number1022781
Policy instance 1
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number00614009
Policy instance 2
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number1022781
Policy instance 1
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number1022781
Policy instance 1

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