401k Plan data: US EYE 401(K) RETIREMENT SAVINGS PLAN plan

US EYE 401(K) RETIREMENT SAVINGS PLAN 401k Plan overview

Plan Name	US EYE 401(K) RETIREMENT SAVINGS PLAN
Plan identification number	002

US EYE 401(K) RETIREMENT SAVINGS PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

Profit-sharing
ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.
Plan sponsor(s) is (are) a member(s) of a controlled group (Code sections 414(b), (c), or (m)).

401k Sponsoring company profile

CFS MANAGEMENT, LLC has sponsored the creation of one or more 401k plans.

Company Name: CFS MANAGEMENT, LLC

Employer identification number (EIN): 834228141

NAIC Classification: 621320
NAIC Description: Offices of Optometrists

Form 5500 Filing Information

Submission information for form 5500 for 401k plan US EYE 401(K) RETIREMENT SAVINGS PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
002 2023-01-01
002 2022-01-01 SHELBY THOMPSON 2023-10-13
002 2021-01-01 SHELBY THOMPSON 2023-03-08
002 2020-01-01 SHELBY THOMPSON 2022-09-09
002 2020-01-01 SHELBY THOMPSON 2022-11-14
002 2019-01-01

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
002	2023-01-01
002	2022-01-01	SHELBY THOMPSON	2023-10-13
002	2021-01-01	SHELBY THOMPSON	2023-03-08
002	2020-01-01	SHELBY THOMPSON	2022-09-09
002	2020-01-01	SHELBY THOMPSON	2022-11-14
002	2019-01-01

Plan Statistics for US EYE 401(K) RETIREMENT SAVINGS PLAN

401k plan membership statisitcs for US EYE 401(K) RETIREMENT SAVINGS PLAN

Measure Date Value
2023: US EYE 401(K) RETIREMENT SAVINGS PLAN 2023 401k membership
Total participants, beginning-of-year 2023-01-01 1,269
Total number of active participants reported on line 7a of the Form 5500 2023-01-01 928
Number of retired or separated participants receiving benefits 2023-01-01 12
Number of other retired or separated participants entitled to future benefits 2023-01-01 114
Total of all active and inactive participants 2023-01-01 1,054
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2023-01-01 1
Total participants 2023-01-01 1,055
Number of participants with account balances 2023-01-01 672
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2023-01-01 42
2022: US EYE 401(K) RETIREMENT SAVINGS PLAN 2022 401k membership
Total participants, beginning-of-year 2022-01-01 840
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 1,100
Number of retired or separated participants receiving benefits 2022-01-01 77
Number of other retired or separated participants entitled to future benefits 2022-01-01 90
Total of all active and inactive participants 2022-01-01 1,267
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2022-01-01 2
Total participants 2022-01-01 1,269
Number of participants with account balances 2022-01-01 779
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2022-01-01 47
2021: US EYE 401(K) RETIREMENT SAVINGS PLAN 2021 401k membership
Total participants, beginning-of-year 2021-01-01 781
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 787
Number of retired or separated participants receiving benefits 2021-01-01 3
Number of other retired or separated participants entitled to future benefits 2021-01-01 49
Total of all active and inactive participants 2021-01-01 839
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2021-01-01 1
Total participants 2021-01-01 840
Number of participants with account balances 2021-01-01 432
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2021-01-01 35
2020: US EYE 401(K) RETIREMENT SAVINGS PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 376
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 339
Number of retired or separated participants receiving benefits 2020-01-01 0
Number of other retired or separated participants entitled to future benefits 2020-01-01 69
Total of all active and inactive participants 2020-01-01 408
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2020-01-01 0
Total participants 2020-01-01 408
Number of participants with account balances 2020-01-01 315
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-01-01 17
2019: US EYE 401(K) RETIREMENT SAVINGS PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 251
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 201
Number of retired or separated participants receiving benefits 2019-01-01 0
Number of other retired or separated participants entitled to future benefits 2019-01-01 62
Total of all active and inactive participants 2019-01-01 263
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-01-01 0
Total participants 2019-01-01 263
Number of participants with account balances 2019-01-01 197
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-01-01 20

Measure	Date	Value
2023: US EYE 401(K) RETIREMENT SAVINGS PLAN 2023 401k membership
Total participants, beginning-of-year	2023-01-01	1,269
Total number of active participants reported on line 7a of the Form 5500	2023-01-01	928
Number of retired or separated participants receiving benefits	2023-01-01	12
Number of other retired or separated participants entitled to future benefits	2023-01-01	114
Total of all active and inactive participants	2023-01-01	1,054
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2023-01-01	1
Total participants	2023-01-01	1,055
Number of participants with account balances	2023-01-01	672
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2023-01-01	42
2022: US EYE 401(K) RETIREMENT SAVINGS PLAN 2022 401k membership
Total participants, beginning-of-year	2022-01-01	840
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	1,100
Number of retired or separated participants receiving benefits	2022-01-01	77
Number of other retired or separated participants entitled to future benefits	2022-01-01	90
Total of all active and inactive participants	2022-01-01	1,267
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2022-01-01	2
Total participants	2022-01-01	1,269
Number of participants with account balances	2022-01-01	779
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2022-01-01	47
2021: US EYE 401(K) RETIREMENT SAVINGS PLAN 2021 401k membership
Total participants, beginning-of-year	2021-01-01	781
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	787
Number of retired or separated participants receiving benefits	2021-01-01	3
Number of other retired or separated participants entitled to future benefits	2021-01-01	49
Total of all active and inactive participants	2021-01-01	839
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2021-01-01	1
Total participants	2021-01-01	840
Number of participants with account balances	2021-01-01	432
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2021-01-01	35
2020: US EYE 401(K) RETIREMENT SAVINGS PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	376
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	339
Number of retired or separated participants receiving benefits	2020-01-01	0
Number of other retired or separated participants entitled to future benefits	2020-01-01	69
Total of all active and inactive participants	2020-01-01	408
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-01-01	0
Total participants	2020-01-01	408
Number of participants with account balances	2020-01-01	315
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-01-01	17
2019: US EYE 401(K) RETIREMENT SAVINGS PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	251
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	201
Number of retired or separated participants receiving benefits	2019-01-01	0
Number of other retired or separated participants entitled to future benefits	2019-01-01	62
Total of all active and inactive participants	2019-01-01	263
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-01-01	0
Total participants	2019-01-01	263
Number of participants with account balances	2019-01-01	197
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-01-01	20

Financial Data on US EYE 401(K) RETIREMENT SAVINGS PLAN

Measure	Date	Value
2023 : US EYE 401(K) RETIREMENT SAVINGS PLAN 2023 401k financial data
Total unrealized appreciation/depreciation of assets	2023-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2023-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2023-12-31	$0
Total income from all sources (including contributions)	2023-12-31	$11,304,346
Total loss/gain on sale of assets	2023-12-31	$0
Total of all expenses incurred	2023-12-31	$3,347,103
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2023-12-31	$3,179,213
Expenses. Certain deemed distributions of participant loans	2023-12-31	$36,296
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2023-12-31	$6,298,645
Value of total assets at end of year	2023-12-31	$34,688,558
Value of total assets at beginning of year	2023-12-31	$26,731,315
Total of administrative expenses incurred including professional, contract, advisory and management fees	2023-12-31	$131,594
Total interest from all sources	2023-12-31	$21,370
Total dividends received (eg from common stock, registered investment company shares)	2023-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2023-12-31	No
Was this plan covered by a fidelity bond	2023-12-31	Yes
Value of fidelity bond cover	2023-12-31	$500,000
If this is an individual account plan, was there a blackout period	2023-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2023-12-31	No
Contributions received from participants	2023-12-31	$3,747,083
Participant contributions at end of year	2023-12-31	$311,322
Participant contributions at beginning of year	2023-12-31	$243,294
Participant contributions at end of year	2023-12-31	$0
Participant contributions at beginning of year	2023-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2023-12-31	$787,827
Value of other receiveables (less allowance for doubtful accounts) at end of year	2023-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2023-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2023-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2023-12-31	$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2023-12-31	No
Value of net income/loss	2023-12-31	$7,957,243
Value of net assets at end of year (total assets less liabilities)	2023-12-31	$34,688,558
Value of net assets at beginning of year (total assets less liabilities)	2023-12-31	$26,731,315
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2023-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2023-12-31	No
Were any leases to which the plan was party in default or uncollectible	2023-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2023-12-31	$32,593,754
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2023-12-31	$24,903,778
Interest on participant loans	2023-12-31	$21,370
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2023-12-31	$1,783,482
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2023-12-31	$1,584,243
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2023-12-31	$4,984,331
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2023-12-31	No
Was there a failure to transmit to the plan any participant contributions	2023-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2023-12-31	No
Contributions received in cash from employer	2023-12-31	$1,763,735
Employer contributions (assets) at end of year	2023-12-31	$0
Employer contributions (assets) at beginning of year	2023-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2023-12-31	$3,179,213
Did the plan have assets held for investment	2023-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2023-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2023-12-31	No
Opinion of an independent qualified public accountant for this plan	2023-12-31	Unqualified
Accountancy firm name	2023-12-31	ASSURANCE DIMENSIONS
Accountancy firm EIN	2023-12-31	263429295
2022 : US EYE 401(K) RETIREMENT SAVINGS PLAN 2022 401k financial data
Total unrealized appreciation/depreciation of assets	2022-12-31	$0
Total transfer of assets to this plan	2022-12-31	$569,337
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2022-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2022-12-31	$0
Total income from all sources (including contributions)	2022-12-31	$3,151,191
Total loss/gain on sale of assets	2022-12-31	$0
Total of all expenses incurred	2022-12-31	$2,367,013
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2022-12-31	$2,266,231
Expenses. Certain deemed distributions of participant loans	2022-12-31	$5,787
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2022-12-31	$7,448,459
Value of total assets at end of year	2022-12-31	$26,731,315
Value of total assets at beginning of year	2022-12-31	$25,377,800
Total of administrative expenses incurred including professional, contract, advisory and management fees	2022-12-31	$94,995
Total interest from all sources	2022-12-31	$13,213
Total dividends received (eg from common stock, registered investment company shares)	2022-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2022-12-31	No
Administrative expenses professional fees incurred	2022-12-31	$82,956
Was this plan covered by a fidelity bond	2022-12-31	Yes
Value of fidelity bond cover	2022-12-31	$500,000
If this is an individual account plan, was there a blackout period	2022-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2022-12-31	No
Contributions received from participants	2022-12-31	$3,548,678
Participant contributions at end of year	2022-12-31	$243,294
Participant contributions at beginning of year	2022-12-31	$205,597
Participant contributions at end of year	2022-12-31	$0
Participant contributions at beginning of year	2022-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2022-12-31	$2,175,381
Value of other receiveables (less allowance for doubtful accounts) at end of year	2022-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2022-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2022-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2022-12-31	$0
Administrative expenses (other) incurred	2022-12-31	$12,039
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2022-12-31	No
Value of net income/loss	2022-12-31	$784,178
Value of net assets at end of year (total assets less liabilities)	2022-12-31	$26,731,315
Value of net assets at beginning of year (total assets less liabilities)	2022-12-31	$25,377,800
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2022-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2022-12-31	No
Were any leases to which the plan was party in default or uncollectible	2022-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2022-12-31	$24,903,778
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2022-12-31	$23,489,543
Interest on participant loans	2022-12-31	$13,213
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2022-12-31	$1,584,243
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2022-12-31	$1,682,660
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2022-12-31	$-4,310,481
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2022-12-31	No
Was there a failure to transmit to the plan any participant contributions	2022-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2022-12-31	No
Contributions received in cash from employer	2022-12-31	$1,724,400
Employer contributions (assets) at end of year	2022-12-31	$0
Employer contributions (assets) at beginning of year	2022-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2022-12-31	$2,266,231
Did the plan have assets held for investment	2022-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2022-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2022-12-31	No
Opinion of an independent qualified public accountant for this plan	2022-12-31	Unqualified
Accountancy firm name	2022-12-31	ASSURANCE DIMENSIONS
Accountancy firm EIN	2022-12-31	263429295
2021 : US EYE 401(K) RETIREMENT SAVINGS PLAN 2021 401k financial data
Total unrealized appreciation/depreciation of assets	2021-12-31	$0
Total transfer of assets to this plan	2021-12-31	$3,553,155
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-12-31	$67,929
Total income from all sources (including contributions)	2021-12-31	$6,884,662
Total loss/gain on sale of assets	2021-12-31	$0
Total of all expenses incurred	2021-12-31	$1,299,596
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2021-12-31	$1,247,771
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2021-12-31	$4,027,069
Value of total assets at end of year	2021-12-31	$25,377,800
Value of total assets at beginning of year	2021-12-31	$16,307,508
Total of administrative expenses incurred including professional, contract, advisory and management fees	2021-12-31	$51,825
Total interest from all sources	2021-12-31	$10,766
Total dividends received (eg from common stock, registered investment company shares)	2021-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2021-12-31	No
Administrative expenses professional fees incurred	2021-12-31	$51,825
Was this plan covered by a fidelity bond	2021-12-31	Yes
Value of fidelity bond cover	2021-12-31	$500,000
If this is an individual account plan, was there a blackout period	2021-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2021-12-31	No
Contributions received from participants	2021-12-31	$1,867,070
Participant contributions at end of year	2021-12-31	$205,597
Participant contributions at beginning of year	2021-12-31	$94,802
Participant contributions at end of year	2021-12-31	$0
Participant contributions at beginning of year	2021-12-31	$25,930
Income. Received or receivable in cash from other sources (including rollovers)	2021-12-31	$1,451,514
Value of other receiveables (less allowance for doubtful accounts) at end of year	2021-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2021-12-31	$131
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2021-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2021-12-31	$67,929
Other income not declared elsewhere	2021-12-31	$54,701
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2021-12-31	No
Value of net income/loss	2021-12-31	$5,585,066
Value of net assets at end of year (total assets less liabilities)	2021-12-31	$25,377,800
Value of net assets at beginning of year (total assets less liabilities)	2021-12-31	$16,239,579
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2021-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2021-12-31	No
Were any leases to which the plan was party in default or uncollectible	2021-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2021-12-31	$23,489,543
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2021-12-31	$14,063,809
Interest on participant loans	2021-12-31	$7,556
Interest earned on other investments	2021-12-31	$3,210
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2021-12-31	$1,682,660
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2021-12-31	$2,112,551
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2021-12-31	$2,792,126
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2021-12-31	No
Was there a failure to transmit to the plan any participant contributions	2021-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2021-12-31	No
Contributions received in cash from employer	2021-12-31	$708,485
Employer contributions (assets) at end of year	2021-12-31	$0
Employer contributions (assets) at beginning of year	2021-12-31	$10,285
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2021-12-31	$1,247,771
Did the plan have assets held for investment	2021-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2021-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2021-12-31	No
Opinion of an independent qualified public accountant for this plan	2021-12-31	Unqualified
Accountancy firm name	2021-12-31	ASSURANCE DIMENSIONS
Accountancy firm EIN	2021-12-31	263429295
2020 : US EYE 401(K) RETIREMENT SAVINGS PLAN 2020 401k financial data
Total unrealized appreciation/depreciation of assets	2020-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-12-31	$79,601
Total income from all sources (including contributions)	2020-12-31	$6,261,034
Total loss/gain on sale of assets	2020-12-31	$0
Total of all expenses incurred	2020-12-31	$615,330
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2020-12-31	$557,392
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2020-12-31	$4,540,980
Value of total assets at end of year	2020-12-31	$16,307,508
Value of total assets at beginning of year	2020-12-31	$10,741,405
Total of administrative expenses incurred including professional, contract, advisory and management fees	2020-12-31	$57,938
Total interest from all sources	2020-12-31	$43,136
Total dividends received (eg from common stock, registered investment company shares)	2020-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2020-12-31	No
Was this plan covered by a fidelity bond	2020-12-31	Yes
Value of fidelity bond cover	2020-12-31	$500,000
If this is an individual account plan, was there a blackout period	2020-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2020-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2020-12-31	No
Contributions received from participants	2020-12-31	$1,031,705
Participant contributions at end of year	2020-12-31	$94,802
Participant contributions at beginning of year	2020-12-31	$78,372
Participant contributions at end of year	2020-12-31	$25,930
Participant contributions at beginning of year	2020-12-31	$12,250
Income. Received or receivable in cash from other sources (including rollovers)	2020-12-31	$3,069,981
Value of other receiveables (less allowance for doubtful accounts) at end of year	2020-12-31	$131
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2020-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2020-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2020-12-31	$79,601
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2020-12-31	No
Value of net income/loss	2020-12-31	$5,645,704
Value of net assets at end of year (total assets less liabilities)	2020-12-31	$16,307,508
Value of net assets at beginning of year (total assets less liabilities)	2020-12-31	$10,661,804
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2020-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2020-12-31	No
Were any leases to which the plan was party in default or uncollectible	2020-12-31	No
Investment advisory and management fees	2020-12-31	$47,085
Value of interest in registered invesment companies (eg mutual funds) at end of year	2020-12-31	$14,063,809
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2020-12-31	$10,281,810
Interest on participant loans	2020-12-31	$8,323
Interest earned on other investments	2020-12-31	$34,813
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2020-12-31	$2,112,551
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2020-12-31	$361,697
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2020-12-31	$1,676,918
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2020-12-31	No
Was there a failure to transmit to the plan any participant contributions	2020-12-31	No
Has the plan failed to provide any benefit when due under the plan	2020-12-31	No
Contributions received in cash from employer	2020-12-31	$439,294
Employer contributions (assets) at end of year	2020-12-31	$10,285
Employer contributions (assets) at beginning of year	2020-12-31	$7,276
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2020-12-31	$557,392
Contract administrator fees	2020-12-31	$10,853
Did the plan have assets held for investment	2020-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2020-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2020-12-31	No
Opinion of an independent qualified public accountant for this plan	2020-12-31	Disclaimer
Accountancy firm name	2020-12-31	SUPLEE SHEA CRAMER & ROCLEIN PA
Accountancy firm EIN	2020-12-31	592213819
2019 : US EYE 401(K) RETIREMENT SAVINGS PLAN 2019 401k financial data
Total unrealized appreciation/depreciation of assets	2019-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$79,601
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$43,425
Total income from all sources (including contributions)	2019-12-31	$2,978,274
Total loss/gain on sale of assets	2019-12-31	$0
Total of all expenses incurred	2019-12-31	$640,647
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$602,384
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$1,098,281
Value of total assets at end of year	2019-12-31	$10,741,405
Value of total assets at beginning of year	2019-12-31	$8,367,602
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$38,263
Total interest from all sources	2019-12-31	$14,759
Total dividends received (eg from common stock, registered investment company shares)	2019-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2019-12-31	No
Was this plan covered by a fidelity bond	2019-12-31	Yes
Value of fidelity bond cover	2019-12-31	$500,000
If this is an individual account plan, was there a blackout period	2019-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2019-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2019-12-31	No
Contributions received from participants	2019-12-31	$699,129
Participant contributions at end of year	2019-12-31	$78,372
Participant contributions at beginning of year	2019-12-31	$44,907
Participant contributions at end of year	2019-12-31	$12,250
Participant contributions at beginning of year	2019-12-31	$23,896
Income. Received or receivable in cash from other sources (including rollovers)	2019-12-31	$52,041
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2019-12-31	$135
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2019-12-31	$79,601
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2019-12-31	$43,425
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-12-31	No
Value of net income/loss	2019-12-31	$2,337,627
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$10,661,804
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$8,324,177
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2019-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2019-12-31	No
Were any leases to which the plan was party in default or uncollectible	2019-12-31	No
Investment advisory and management fees	2019-12-31	$30,685
Value of interest in registered invesment companies (eg mutual funds) at end of year	2019-12-31	$10,281,810
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2019-12-31	$7,862,562
Interest on participant loans	2019-12-31	$4,816
Interest earned on other investments	2019-12-31	$9,943
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2019-12-31	$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2019-12-31	$2,197
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2019-12-31	$2,197
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2019-12-31	$361,697
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2019-12-31	$422,114
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2019-12-31	$1,865,234
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2019-12-31	No
Was there a failure to transmit to the plan any participant contributions	2019-12-31	No
Has the plan failed to provide any benefit when due under the plan	2019-12-31	No
Contributions received in cash from employer	2019-12-31	$347,111
Employer contributions (assets) at end of year	2019-12-31	$7,276
Employer contributions (assets) at beginning of year	2019-12-31	$11,791
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-31	$602,384
Contract administrator fees	2019-12-31	$7,578
Did the plan have assets held for investment	2019-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2019-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2019-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2019-12-31	Disclaimer
Accountancy firm name	2019-12-31	SUPLEE SHEA CRAMER & ROCKLEIN PA
Accountancy firm EIN	2019-12-31	592213819

Form 5500 Responses for US EYE 401(K) RETIREMENT SAVINGS PLAN

2023: US EYE 401(K) RETIREMENT SAVINGS PLAN 2023 form 5500 responses
2023-01-01	Type of plan entity	Mulitple employer plan
2023-01-01	Submission has been amended	Yes
2023-01-01	This submission is the final filing	No
2023-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2023-01-01	Plan is a collectively bargained plan	No
2023-01-01	Plan funding arrangement – Insurance	Yes
2023-01-01	Plan funding arrangement – Trust	Yes
2023-01-01	Plan benefit arrangement – Insurance	Yes
2023-01-01	Plan benefit arrangement - Trust	Yes
2022: US EYE 401(K) RETIREMENT SAVINGS PLAN 2022 form 5500 responses
2022-01-01	Type of plan entity	Mulitple employer plan
2022-01-01	Submission has been amended	No
2022-01-01	This submission is the final filing	No
2022-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2022-01-01	Plan is a collectively bargained plan	No
2022-01-01	Plan funding arrangement – Insurance	Yes
2022-01-01	Plan funding arrangement – Trust	Yes
2022-01-01	Plan benefit arrangement – Insurance	Yes
2022-01-01	Plan benefit arrangement - Trust	Yes
2021: US EYE 401(K) RETIREMENT SAVINGS PLAN 2021 form 5500 responses
2021-01-01	Type of plan entity	Mulitple employer plan
2021-01-01	Submission has been amended	No
2021-01-01	This submission is the final filing	No
2021-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2021-01-01	Plan is a collectively bargained plan	No
2021-01-01	Plan funding arrangement – Insurance	Yes
2021-01-01	Plan funding arrangement – Trust	Yes
2021-01-01	Plan benefit arrangement – Insurance	Yes
2021-01-01	Plan benefit arrangement - Trust	Yes
2020: US EYE 401(K) RETIREMENT SAVINGS PLAN 2020 form 5500 responses
2020-01-01	Type of plan entity	Single employer plan
2020-01-01	Submission has been amended	No
2020-01-01	This submission is the final filing	No
2020-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2020-01-01	Plan is a collectively bargained plan	No
2020-01-01	Plan funding arrangement – Insurance	Yes
2020-01-01	Plan funding arrangement – Trust	Yes
2020-01-01	Plan benefit arrangement – Insurance	Yes
2020-01-01	Plan benefit arrangement - Trust	Yes
2019: US EYE 401(K) RETIREMENT SAVINGS PLAN 2019 form 5500 responses
2019-01-01	Type of plan entity	Single employer plan
2019-01-01	Submission has been amended	No
2019-01-01	This submission is the final filing	No
2019-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2019-01-01	Plan is a collectively bargained plan	No
2019-01-01	Plan funding arrangement – Insurance	Yes
2019-01-01	Plan funding arrangement – Trust	Yes
2019-01-01	Plan benefit arrangement – Insurance	Yes
2019-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )

Policy contract number

1260864-01

Policy instance

Insurance contract or identification number	1260864-01
Number of Individuals Covered	112
Insurance policy start date	2023-01-01
Insurance policy end date	2023-12-31
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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )

Policy contract number

1260864-01

Policy instance

Insurance contract or identification number	1260864-01
Number of Individuals Covered	84
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )

Policy contract number

GAP-CP-KS5N

Policy instance

Insurance contract or identification number	GAP-CP-KS5N
Number of Individuals Covered	0
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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?	Yes
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )

Policy contract number

1260864-01

Policy instance

Insurance contract or identification number	1260864-01
Number of Individuals Covered	86
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )

Policy contract number

GAP-CP-KS5N

Policy instance

Insurance contract or identification number	GAP-CP-KS5N
Number of Individuals Covered	315
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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?	Yes
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )

Policy contract number

GAP-CP-KS5N

Policy instance

Insurance contract or identification number	GAP-CP-KS5N
Number of Individuals Covered	197
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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?	Yes
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No

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Company Name:	CFS MANAGEMENT, LLC
Employer identification number (EIN):	834228141
NAIC Classification:	621320
NAIC Description:	Offices of Optometrists