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| Plan Name | SOUTH DENVER GASTROENTEROLOGY GROUP LIFE AND AD&D |
| Plan identification number | 502 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | GI CARE OF COLORADO |
| Employer identification number (EIN): | 843173268 |
| 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 |
|---|---|---|---|---|---|
| 502 | 2021-01-01 | BRANDEN LISH | 2022-08-12 | ||
| 502 | 2020-01-01 | RICHARD ROMAN | 2021-07-28 |
| Measure | Date | Value |
|---|---|---|
| 2021: SOUTH DENVER GASTROENTEROLOGY GROUP LIFE AND AD&D 2021 401k membership | ||
| Total participants, beginning-of-year | 2021-01-01 | 119 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-01-01 | 116 |
| Number of retired or separated participants receiving benefits | 2021-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2021-01-01 | 3 |
| Total of all active and inactive participants | 2021-01-01 | 119 |
| Number of employers contributing to the scheme | 2021-01-01 | 0 |
| 2020: SOUTH DENVER GASTROENTEROLOGY GROUP LIFE AND AD&D 2020 401k membership | ||
| Total participants, beginning-of-year | 2020-01-01 | 163 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-01-01 | 0 |
| 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 | 0 |
| Total of all active and inactive participants | 2020-01-01 | 0 |
| Number of employers contributing to the scheme | 2020-01-01 | 0 |
| 2021: SOUTH DENVER GASTROENTEROLOGY GROUP LIFE AND AD&D 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: SOUTH DENVER GASTROENTEROLOGY GROUP LIFE AND AD&D 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 | This submission is the final filing | Yes |
| 2020-01-01 | Plan funding arrangement – Insurance | Yes |
| 2020-01-01 | Plan benefit arrangement – Insurance | Yes |
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) | |||||||||||||||||||||||||||||||
| Policy contract number | 676622G | ||||||||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||||||||
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| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) | |||||||||||||||||||||||||||||||
| Policy contract number | 502 | ||||||||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||||||||
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