401k Plan data: MEDQUEST ASSOCIATES, INC. WELFARE BENEFITS PLAN plan

MEDQUEST ASSOCIATES, INC. WELFARE BENEFITS PLAN 401k Plan overview

Plan Name	MEDQUEST ASSOCIATES, INC. WELFARE BENEFITS PLAN
Plan identification number	503

MEDQUEST ASSOCIATES, INC. WELFARE BENEFITS PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) Life insurance Dental Vision Temporary disability (accident and sickness) Long-term disability cover Death benefits (include travel accident but not life insurance) Other welfare benefit cover

401k Sponsoring company profile

MEDQUEST ASSOCIATES, INC. has sponsored the creation of one or more 401k plans.

Company Name: MEDQUEST ASSOCIATES, INC.

Employer identification number (EIN): 570997427

NAIC Classification: 621399
NAIC Description: Offices of All Other Miscellaneous Health Practitioners

Additional information about MEDQUEST ASSOCIATES, INC.

Jurisdiction of Incorporation: Texas Secretary of State

Incorporation Date: 2015-09-01

Company Identification Number: 0802284373

Legal Registered Office Address: 211 E 7TH ST STE 620

AUSTIN
United States of America (USA)
78701

More information about MEDQUEST ASSOCIATES, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan MEDQUEST ASSOCIATES, INC. WELFARE BENEFITS PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
503 2024-01-01 MICHELE FOX
503 2023-01-01
503 2023-01-01 KRISTINA MCMAHON
503 2022-01-01
503 2022-01-01 KRISTINA MCMAHON
503 2021-01-01
503 2021-01-01 KRISTINA MCMAHON
503 2020-09-01

Form 5500 Responses for MEDQUEST ASSOCIATES, INC. WELFARE BENEFITS PLAN

2023: MEDQUEST ASSOCIATES, INC. WELFARE BENEFITS PLAN 2023 form 5500 responses
2023-01-01	Type of plan entity	Single employer plan
2023-01-01	Plan funding arrangement – Insurance	Yes
2023-01-01	Plan benefit arrangement – Insurance	Yes
2022: MEDQUEST ASSOCIATES, INC. WELFARE BENEFITS 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 benefit arrangement – Insurance	Yes
2021: MEDQUEST ASSOCIATES, INC. WELFARE BENEFITS 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 benefit arrangement – Insurance	Yes
2020: MEDQUEST ASSOCIATES, INC. WELFARE BENEFITS PLAN 2020 form 5500 responses
2020-09-01	Type of plan entity	Single employer plan
2020-09-01	First time form 5500 has been submitted	Yes
2020-09-01	This return/report is a short plan year return/report (less than 12 months)	Yes
2020-09-01	Plan funding arrangement – Insurance	Yes
2020-09-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 )

Policy contract number

HCL38047

Policy instance

Insurance contract or identification number	HCL38047
Number of Individuals Covered	333
Insurance policy start date	2023-01-01
Insurance policy end date	2023-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $27,030
Welfare Benefit Premiums Paid to Carrier	USD $540,603
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )

Policy contract number

GLTD0B8QT

Policy instance

Insurance contract or identification number	GLTD0B8QT
Number of Individuals Covered	418
Insurance policy start date	2023-01-01
Insurance policy end date	2023-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $5,471
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $107,066
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )

Policy contract number

GLUG0B8QT

Policy instance

Insurance contract or identification number	GLUG0B8QT
Number of Individuals Covered	418
Insurance policy start date	2023-01-01
Insurance policy end date	2023-12-31
Total amount of commissions paid to insurance broker	USD $450
Total amount of fees paid to insurance company	USD $482
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	AD&D
Welfare Benefit Premiums Paid to Carrier	USD $9,007
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )

Policy contract number

GUC0B8QT

Policy instance

Insurance contract or identification number	GUC0B8QT
Number of Individuals Covered	295
Insurance policy start date	2023-01-01
Insurance policy end date	2023-12-31
Total amount of commissions paid to insurance broker	USD $4,854
Total amount of fees paid to insurance company	USD $5,123
Temporary Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $97,087
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )

Policy contract number

GVTL0B8QT

Policy instance

Insurance contract or identification number	GVTL0B8QT
Number of Individuals Covered	257
Insurance policy start date	2023-01-01
Insurance policy end date	2023-12-31
Total amount of commissions paid to insurance broker	USD $12,896
Total amount of fees paid to insurance company	USD $6,765
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $128,957
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

BLUE CROSS BLUE SHIELD OF GEORGIA INC. (G0386) (National Association of Insurance Commissioners NAIC id number: 96962 )

Policy contract number

L01224

Policy instance

Insurance contract or identification number	L01224
Number of Individuals Covered	335
Insurance policy start date	2023-01-01
Insurance policy end date	2023-12-31
Total amount of commissions paid to insurance broker	USD $42,543
Total amount of fees paid to insurance company	USD $3,351
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Other welfare benefits provided	EAP/OTHER
Welfare Benefit Premiums Paid to Carrier	USD $309,877
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 )

Policy contract number

EXRK

Policy instance

Insurance contract or identification number	EXRK
Number of Individuals Covered	319
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $28,367
Welfare Benefit Premiums Paid to Carrier	USD $567,345
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

BLUE CROSS BLUE SHIELD OF GEORGIA INC. (G0386) (National Association of Insurance Commissioners NAIC id number: 96962 )

Policy contract number

L01224

Policy instance

Insurance contract or identification number	L01224
Number of Individuals Covered	319
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $25,303
Total amount of fees paid to insurance company	USD $1,934
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $256,359
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )

Policy contract number

GVTL0B8QT

Policy instance

Insurance contract or identification number	GVTL0B8QT
Number of Individuals Covered	245
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $12,254
Total amount of fees paid to insurance company	USD $3,989
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $122,542
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )

Policy contract number

GUC0B8QT

Policy instance

Insurance contract or identification number	GUC0B8QT
Number of Individuals Covered	285
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $4,651
Total amount of fees paid to insurance company	USD $3,066
Temporary Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $93,013
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )

Policy contract number

GLUG0B8QT

Policy instance

Insurance contract or identification number	GLUG0B8QT
Number of Individuals Covered	302
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $438
Total amount of fees paid to insurance company	USD $302
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	AD&D
Welfare Benefit Premiums Paid to Carrier	USD $8,759
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )

Policy contract number

GLTD0B8QT

Policy instance

Insurance contract or identification number	GLTD0B8QT
Number of Individuals Covered	392
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $3,320
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $99,399
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

BLUE CROSS BLUE SHIELD OF GEORGIA INC. (G0386) (National Association of Insurance Commissioners NAIC id number: 96962 )

Policy contract number

L01224

Policy instance

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )

Policy contract number

GVTL0B8QT

Policy instance

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )

Policy contract number

GUC0B8QT

Policy instance

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )

Policy contract number

GLUG0B8QT

Policy instance

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )

Policy contract number

GLTD0B8QT

Policy instance

VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 32395 )

Policy contract number

30062201

Policy instance

CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )

Policy contract number

3339389

Policy instance

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )

Policy contract number

GLUG0B8QT

Policy instance

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )

Policy contract number

GUC0B8QT

Policy instance

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )

Policy contract number

GVTL0B8QT

Policy instance

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )

Policy contract number

GLTD0B8QT

Policy instance

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Company Name:	MEDQUEST ASSOCIATES, INC.
Employer identification number (EIN):	570997427
NAIC Classification:	621399
NAIC Description:	Offices of All Other Miscellaneous Health Practitioners

Jurisdiction of Incorporation:	Texas Secretary of State
Incorporation Date:	2015-09-01
Company Identification Number:	0802284373
Legal Registered Office Address:	211 E 7TH ST STE 620 AUSTIN United States of America (USA) 78701

Plan id#	Filing Submission Date	Name of Administrator
503	2024-01-01	MICHELE FOX
503	2023-01-01
503	2023-01-01	KRISTINA MCMAHON
503	2022-01-01
503	2022-01-01	KRISTINA MCMAHON
503	2021-01-01
503	2021-01-01	KRISTINA MCMAHON
503	2020-09-01