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LIONS EYE INSTITUTE FOR TRANSPLANT & RESEARCH GROUP DENTAL, LIFE & DISABILITY PLAN 401k Plan overview

Plan NameLIONS EYE INSTITUTE FOR TRANSPLANT & RESEARCH GROUP DENTAL, LIFE & DISABILITY PLAN
Plan identification number 502

LIONS EYE INSTITUTE FOR TRANSPLANT & RESEARCH GROUP DENTAL, LIFE & DISABILITY PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Life insurance
  • Dental
  • Temporary disability (accident and sickness)
  • Long-term disability cover
  • Other welfare benefit cover

401k Sponsoring company profile

LIONS EYE INSTITUTE FOR TRANSPLANT AND RESEARCH, INC. has sponsored the creation of one or more 401k plans.

Company Name:LIONS EYE INSTITUTE FOR TRANSPLANT AND RESEARCH, INC.
Employer identification number (EIN):591458151
NAIC Classification:621111
NAIC Description:Offices of Physicians (except Mental Health Specialists)

Form 5500 Filing Information

Submission information for form 5500 for 401k plan LIONS EYE INSTITUTE FOR TRANSPLANT & RESEARCH GROUP DENTAL, LIFE & DISABILITY PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5022019-01-01

Plan Statistics for LIONS EYE INSTITUTE FOR TRANSPLANT & RESEARCH GROUP DENTAL, LIFE & DISABILITY PLAN

401k plan membership statisitcs for LIONS EYE INSTITUTE FOR TRANSPLANT & RESEARCH GROUP DENTAL, LIFE & DISABILITY PLAN

Measure Date Value
2019: LIONS EYE INSTITUTE FOR TRANSPLANT & RESEARCH GROUP DENTAL, LIFE & DISABILITY PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-01116
Total number of active participants reported on line 7a of the Form 55002019-01-010
Number of retired or separated participants receiving benefits2019-01-010
Number of other retired or separated participants entitled to future benefits2019-01-010
Total of all active and inactive participants2019-01-010

Form 5500 Responses for LIONS EYE INSTITUTE FOR TRANSPLANT & RESEARCH GROUP DENTAL, LIFE & DISABILITY PLAN

2019: LIONS EYE INSTITUTE FOR TRANSPLANT & RESEARCH GROUP DENTAL, LIFE & DISABILITY PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01First time form 5500 has been submittedYes
2019-01-01Submission has been amendedNo
2019-01-01This submission is the final filingYes
2019-01-01This return/report is a short plan year return/report (less than 12 months)No
2019-01-01Plan is a collectively bargained planNo
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000AVCX
Policy instance 1
Insurance contract or identification numberG000AVCX
Number of Individuals Covered119
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $13,209
Total amount of fees paid to insurance companyUSD $4,179
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedAD&D
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $152,139
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $13,209
Insurance broker organization code?3
Amount paid for insurance broker fees4179
Additional information about fees paid to insurance brokerADDITIONAL BROKER COMPENSATION

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