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SUMMIT EMERGENCY PHYSICIANS HEALTH AND WELFARE PLAN 401k Plan overview

Plan NameSUMMIT EMERGENCY PHYSICIANS HEALTH AND WELFARE PLAN
Plan identification number 501

SUMMIT EMERGENCY PHYSICIANS HEALTH AND WELFARE PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Dental
  • Vision

401k Sponsoring company profile

SUMMIT EMERGENCY PHYSICIANS has sponsored the creation of one or more 401k plans.

Company Name:SUMMIT EMERGENCY PHYSICIANS
Employer identification number (EIN):710863828
NAIC Classification:621111
NAIC Description:Offices of Physicians (except Mental Health Specialists)

Additional information about SUMMIT EMERGENCY PHYSICIANS

Jurisdiction of Incorporation: Georgia Department of States Corporations Division
Incorporation Date:
Company Identification Number: 104056

More information about SUMMIT EMERGENCY PHYSICIANS

Form 5500 Filing Information

Submission information for form 5500 for 401k plan SUMMIT EMERGENCY PHYSICIANS HEALTH AND WELFARE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012020-12-01JENNIFER HALL2021-09-08
5012019-12-01JENNIFER HALL2021-09-08

Plan Statistics for SUMMIT EMERGENCY PHYSICIANS HEALTH AND WELFARE PLAN

401k plan membership statisitcs for SUMMIT EMERGENCY PHYSICIANS HEALTH AND WELFARE PLAN

Measure Date Value
2020: SUMMIT EMERGENCY PHYSICIANS HEALTH AND WELFARE PLAN 2020 401k membership
Total participants, beginning-of-year2020-12-01145
Total number of active participants reported on line 7a of the Form 55002020-12-010
Number of retired or separated participants receiving benefits2020-12-010
Number of other retired or separated participants entitled to future benefits2020-12-010
Total of all active and inactive participants2020-12-010
Number of employers contributing to the scheme2020-12-010
2019: SUMMIT EMERGENCY PHYSICIANS HEALTH AND WELFARE PLAN 2019 401k membership
Total participants, beginning-of-year2019-12-01100
Total number of active participants reported on line 7a of the Form 55002019-12-01145
Number of retired or separated participants receiving benefits2019-12-010
Number of other retired or separated participants entitled to future benefits2019-12-010
Total of all active and inactive participants2019-12-01145
Number of employers contributing to the scheme2019-12-010

Form 5500 Responses for SUMMIT EMERGENCY PHYSICIANS HEALTH AND WELFARE PLAN

2020: SUMMIT EMERGENCY PHYSICIANS HEALTH AND WELFARE PLAN 2020 form 5500 responses
2020-12-01Type of plan entitySingle employer plan
2020-12-01This submission is the final filingYes
2020-12-01This return/report is a short plan year return/report (less than 12 months)Yes
2020-12-01Plan funding arrangement – InsuranceYes
2020-12-01Plan benefit arrangement – InsuranceYes
2019: SUMMIT EMERGENCY PHYSICIANS HEALTH AND WELFARE PLAN 2019 form 5500 responses
2019-12-01Type of plan entitySingle employer plan
2019-12-01First time form 5500 has been submittedYes
2019-12-01Plan funding arrangement – InsuranceYes
2019-12-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

BLUE CROSS BLUE SHIELD OF GEORGIA INC. (G0386) (National Association of Insurance Commissioners NAIC id number: 96962 )
Policy contract numberGA9286
Policy instance 1
Insurance contract or identification numberGA9286
Number of Individuals Covered0
Insurance policy start date2020-12-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $5,392
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $5,392
Amount paid for insurance broker fees0
Insurance broker organization code?3
BLUE CROSS BLUE SHIELD OF GEORGIA INC. (G0386) (National Association of Insurance Commissioners NAIC id number: 96962 )
Policy contract numberGA9286
Policy instance 1
Insurance contract or identification numberGA9286
Number of Individuals Covered1238
Insurance policy start date2019-12-01
Insurance policy end date2020-11-30
Total amount of commissions paid to insurance brokerUSD $60,969
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $964,130
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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