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MEDFORD RADIOLOGICAL GROUP, PC. 401k Plan overview

Plan NameMEDFORD RADIOLOGICAL GROUP, PC.
Plan identification number 501

MEDFORD RADIOLOGICAL GROUP, PC. Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Dental
  • Vision
  • Unfunded, fully insured, or combination unfunded/insured welfare plan that will not file a Form 5500 for next plan year pursuant to 29 CFR 2520.104-20.

401k Sponsoring company profile

MEDFORD RADIOLOGICAL GROUP, P.C. has sponsored the creation of one or more 401k plans.

Company Name:MEDFORD RADIOLOGICAL GROUP, P.C.
Employer identification number (EIN):930739801
NAIC Classification:621111
NAIC Description:Offices of Physicians (except Mental Health Specialists)

Form 5500 Filing Information

Submission information for form 5500 for 401k plan MEDFORD RADIOLOGICAL GROUP, PC.

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012021-01-01JOE PASTRANO2022-03-29
5012020-01-01JOE PASTRANO2021-06-30

Plan Statistics for MEDFORD RADIOLOGICAL GROUP, PC.

401k plan membership statisitcs for MEDFORD RADIOLOGICAL GROUP, PC.

Measure Date Value
2021: MEDFORD RADIOLOGICAL GROUP, PC. 2021 401k membership
Total participants, beginning-of-year2021-01-01106
Total number of active participants reported on line 7a of the Form 55002021-01-0191
Number of retired or separated participants receiving benefits2021-01-010
Number of other retired or separated participants entitled to future benefits2021-01-010
Total of all active and inactive participants2021-01-0191
Number of employers contributing to the scheme2021-01-010
2020: MEDFORD RADIOLOGICAL GROUP, PC. 2020 401k membership
Total participants, beginning-of-year2020-01-01105
Total number of active participants reported on line 7a of the Form 55002020-01-01106
Number of retired or separated participants receiving benefits2020-01-010
Number of other retired or separated participants entitled to future benefits2020-01-010
Total of all active and inactive participants2020-01-01106
Number of employers contributing to the scheme2020-01-010

Form 5500 Responses for MEDFORD RADIOLOGICAL GROUP, PC.

2021: MEDFORD RADIOLOGICAL GROUP, PC. 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan benefit arrangement – InsuranceYes
2020: MEDFORD RADIOLOGICAL GROUP, PC. 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01First time form 5500 has been submittedYes
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

REGENCE BLUECROSS BLUESHIELD OF OREGON (National Association of Insurance Commissioners NAIC id number: 54933 )
Policy contract number10044715
Policy instance 1
Insurance contract or identification number10044715
Number of Individuals Covered209
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $23,960
Total amount of fees paid to insurance companyUSD $63
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,215,367
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $23,960
Amount paid for insurance broker fees63
Additional information about fees paid to insurance brokerNON-MONETARY COMPENSATION
Insurance broker organization code?3
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number1066796
Policy instance 2
Insurance contract or identification number1066796
Number of Individuals Covered216
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $5,977
Total amount of fees paid to insurance companyUSD $1,282
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $118,127
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,977
Amount paid for insurance broker fees1282
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
REGENCE BLUECROSS BLUESHIELD OF OREGON (National Association of Insurance Commissioners NAIC id number: 54933 )
Policy contract number10044715
Policy instance 1
Insurance contract or identification number10044715
Number of Individuals Covered252
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $25,020
Total amount of fees paid to insurance companyUSD $6,300
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,217,546
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $20,860
Amount paid for insurance broker fees6300
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number1066796
Policy instance 2
Insurance contract or identification number1066796
Number of Individuals Covered269
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $6,612
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $140,712
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,477
Amount paid for insurance broker fees0
Insurance broker organization code?3

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