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| Plan Name | SIGHTMD EYEMED VISION CARE |
| Plan identification number | 503 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | SIGHT MEDICAL DOCTORS, PLLC |
| Employer identification number (EIN): | 464449523 |
| 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 |
|---|---|---|---|---|---|
| 503 | 2023-01-01 | SHERYL BLUMBERG | 2024-12-06 | ||
| 503 | 2022-01-01 | JEAN SKARIA | 2023-06-27 | ||
| 503 | 2021-01-01 | DEB DAVIS | 2022-07-19 | ||
| 503 | 2020-01-01 | CATHLEEN MASSARO | 2021-07-21 |
| 2023: SIGHTMD EYEMED VISION CARE 2023 form 5500 responses | ||
|---|---|---|
| 2023-01-01 | Type of plan entity | Single employer plan |
| 2023-01-01 | Submission has been amended | Yes |
| 2023-01-01 | Plan funding arrangement – Insurance | Yes |
| 2023-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2022: SIGHTMD EYEMED VISION CARE 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 benefit arrangement – Insurance | Yes |
| 2021: SIGHTMD EYEMED VISION CARE 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 benefit arrangement – Insurance | Yes |
| 2020: SIGHTMD EYEMED VISION CARE 2020 form 5500 responses | ||
| 2020-01-01 | Type of plan entity | Single employer plan |
| 2020-01-01 | First time form 5500 has been submitted | Yes |
| 2020-01-01 | Plan funding arrangement – Insurance | Yes |
| 2020-01-01 | Plan benefit arrangement – Insurance | Yes |
| FIDELITY SECURITY LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 67288 ) | |||||||||||||||||||
| Policy contract number | 10255801001 | ||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||
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| FIDELITY SECURITY LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 67288 ) | |||||||||||||||||||
| Policy contract number | 10255801001 | ||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||
| |||||||||||||||||||
| FIDELITY SECURITY LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 67288 ) | |||||||||||||||||||
| Policy contract number | 10255801001 | ||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||
| FIDELITY SECURITY LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 67288 ) | |||||||||||||||||||
| Policy contract number | 10255801001 | ||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||
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