NEW YORK LIFE BASIC AD&D
|
2023
|
831485877
|
2024-10-25
|
VISIONPOINT EYE CENTER, PLLC
|
103
|
|
File |
View Page
|
Three-digit plan number (PN) |
502
|
Effective date of plan |
2023-08-01
|
Business code |
621111
|
Sponsor’s telephone number |
3096627700
|
Plan sponsor’s mailing address |
1107 AIRPORT RD, BLOOMINGTON, IL, 617042544
|
Plan sponsor’s
address |
1107 AIRPORT RD, BLOOMINGTON, IL, 617042544
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2024-10-25 |
Name of individual signing |
KRISTI ORRICK |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
NEW YORK LIFE SHORT TERM DISABILITY
|
2023
|
831485877
|
2024-10-25
|
VISIONPOINT EYE CENTER, PLLC
|
103
|
|
File |
View Page
|
Three-digit plan number (PN) |
503
|
Effective date of plan |
2023-08-01
|
Business code |
621111
|
Sponsor’s telephone number |
3096627700
|
Plan sponsor’s mailing address |
1107 AIRPORT RD, BLOOMINGTON, IL, 617042544
|
Plan sponsor’s
address |
1107 AIRPORT RD, BLOOMINGTON, IL, 617042544
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2024-10-25 |
Name of individual signing |
KRISTI ORRICK |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
NEW YORK LIFE LONG TERM DISABILITY
|
2023
|
831485877
|
2024-10-25
|
VISIONPOINT EYE CENTER, PLLC
|
104
|
|
File |
View Page
|
Three-digit plan number (PN) |
504
|
Effective date of plan |
2023-08-01
|
Business code |
621111
|
Sponsor’s telephone number |
3096627700
|
Plan sponsor’s mailing address |
1107 AIRPORT RD, BLOOMINGTON, IL, 617042544
|
Plan sponsor’s
address |
1107 AIRPORT RD, BLOOMINGTON, IL, 617042544
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2024-10-25 |
Name of individual signing |
KRISTI ORRICK |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
NEW YORK LIFE BASIC LIFE
|
2023
|
831485877
|
2024-10-25
|
VISIONPOINT EYE CENTER, PLLC
|
104
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
2023-08-01
|
Business code |
621111
|
Sponsor’s telephone number |
3096627700
|
Plan sponsor’s mailing address |
1107 AIRPORT RD, BLOOMINGTON, IL, 617042544
|
Plan sponsor’s
address |
1107 AIRPORT RD, BLOOMINGTON, IL, 617042544
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2024-10-25 |
Name of individual signing |
KRISTI ORRICK |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
NEW YORK LIFE LONG TERM DISABILITY
|
2022
|
831485877
|
2023-10-10
|
VISIONPOINT EYE CENTER, PLLC
|
98
|
|
File |
View Page
|
Three-digit plan number (PN) |
504
|
Effective date of plan |
2022-08-01
|
Business code |
621111
|
Sponsor’s telephone number |
3096627700
|
Plan sponsor’s mailing address |
1107 AIRPORT RD, BLOOMINGTON, IL, 617042544
|
Plan sponsor’s
address |
1107 AIRPORT RD, BLOOMINGTON, IL, 617042544
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2023-10-10 |
Name of individual signing |
KRISTI ORRICK |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
NEW YORK LIFE BASIC AD&D
|
2022
|
831485877
|
2023-10-02
|
VISIONPOINT EYE CENTER, PLLC
|
101
|
|
File |
View Page
|
Three-digit plan number (PN) |
502
|
Effective date of plan |
2022-08-01
|
Business code |
621111
|
Sponsor’s telephone number |
3096627700
|
Plan sponsor’s mailing address |
1107 AIRPORT RD, BLOOMINGTON, IL, 617042544
|
Plan sponsor’s
address |
1107 AIRPORT RD, BLOOMINGTON, IL, 617042544
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2023-10-02 |
Name of individual signing |
KRISTI ORRICK |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
NEW YORK LIFE BASIC LIFE
|
2022
|
831485877
|
2023-10-02
|
VISIONPOINT EYE CENTER, PLLC
|
101
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
2022-08-01
|
Business code |
621111
|
Sponsor’s telephone number |
3096627700
|
Plan sponsor’s mailing address |
1107 AIRPORT RD, BLOOMINGTON, IL, 617042544
|
Plan sponsor’s
address |
1107 AIRPORT RD, BLOOMINGTON, IL, 617042544
|
Number of participants as of the end of the plan year
Active participants |
103 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Deceased participants
whose
beneficiaries are receiving or are entitled to receive benefits |
0 |
Number of
participants
with
account balances as of the end of the plan year |
0 |
Number of participants that
terminated
employment during the plan year with accrued benefits that were less than 100%
vested |
0 |
Signature of
Role |
Plan administrator |
Date |
2023-10-02 |
Name of individual signing |
KRISTI ORRICK |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
NEW YORK LIFE SHORT TERM DISABILITY
|
2022
|
831485877
|
2023-10-02
|
VISIONPOINT EYE CENTER, PLLC
|
101
|
|
File |
View Page
|
Three-digit plan number (PN) |
503
|
Effective date of plan |
2022-08-01
|
Business code |
621111
|
Sponsor’s telephone number |
3096627700
|
Plan sponsor’s mailing address |
1107 AIRPORT RD, BLOOMINGTON, IL, 617042544
|
Plan sponsor’s
address |
1107 AIRPORT RD, BLOOMINGTON, IL, 617042544
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2023-10-02 |
Name of individual signing |
KRISTI ORRICK |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
NEW YORK LIFE BASIC AD&D
|
2021
|
831485877
|
2023-05-19
|
VISIONPOINT EYE CENTER, PLLC
|
100
|
|
File |
View Page
|
Three-digit plan number (PN) |
502
|
Effective date of plan |
2021-08-01
|
Business code |
621111
|
Sponsor’s telephone number |
3096627700
|
Plan sponsor’s mailing address |
1107 AIRPORT RD, BLOOMINGTON, IL, 617042544
|
Plan sponsor’s
address |
1107 AIRPORT RD, BLOOMINGTON, IL, 617042544
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2023-05-19 |
Name of individual signing |
KRISTI ORRICK |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
NEW YORK LIFE SHORT TERM DISABILITY
|
2021
|
831485877
|
2023-05-19
|
VISIONPOINT EYE CENTER, PLLC
|
100
|
|
File |
View Page
|
Three-digit plan number (PN) |
503
|
Effective date of plan |
2021-08-01
|
Business code |
621111
|
Sponsor’s telephone number |
3096627700
|
Plan sponsor’s mailing address |
1107 AIRPORT RD, BLOOMINGTON, IL, 617042544
|
Plan sponsor’s
address |
1107 AIRPORT RD, BLOOMINGTON, IL, 617042544
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2023-05-19 |
Name of individual signing |
KRISTI ORRICK |
Valid signature |
Filed with authorized/valid electronic signature |
|
|