Vision Service Plan Employees Benefit Plan — Form 5500 plan (Vision Service Plan)
Plain-English plan summary
According to public Form 5500 filings published through the U.S. Department of Labor (DOL) Employee Benefits Security Administration (EBSA) via the EFAST2 system, Vision Service Plan Employees Benefit Plan is a benefit plan reported by Vision Service Plan under EIN 94-1632821 and plan number 501. The latest loaded filing year is 2023. The filing reports 5,000 participants and not reported in the loaded dataset in end-of-year plan assets, where available in the loaded dataset.
Form 5500 plan profile · 2023
Key reported metrics
Net assets (EOY)Not reported
Participants5KCovered participants reported5,000
Assets / participantNot reported
Provider compensation$2M2 Schedule C provider row(s)$2,024,748
- Plan sponsor
- Vision Service Plan
- EIN
- 94-1632821
- Plan number
- 501
- Plan type
- 3
- Location
- Rancho Cordova, CA
- Latest filing year
- 2023
Form 5500 filing history
| Filing year | Participants | Schedules | Filing |
|---|---|---|---|
| 2023 | 5,000 | C | 20241007103028NAL0015928545001 |
Reported financial statement
This plan is loaded, but Schedule H / I financial-statement detail is not present for it in the current loaded dataset.
Service provider compensation (Schedule C)
| Provider | Service | Direct comp. | Indirect comp. | Year |
|---|---|---|---|---|
| Blue Cross Blue Shield Of Michigan | CLAIMS ADMINISTRATION | $1,727,861 | $0 | 2023 |
| Evernorth Behavioral Health, Inc. | EAP ADMINISTRATION | $296,887 | not reported in the loaded dataset | 2023 |