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LAKEWOOD HEALTH CARE CENTER INC HEALTH INSURANCE PLAN 401k Plan overview

Plan NameLAKEWOOD HEALTH CARE CENTER INC HEALTH INSURANCE PLAN
Plan identification number 502

LAKEWOOD HEALTH CARE CENTER INC HEALTH INSURANCE PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Vision

401k Sponsoring company profile

LAKEWOOD HEALTH CARE CENTER INC has sponsored the creation of one or more 401k plans.

Company Name:LAKEWOOD HEALTH CARE CENTER INC
Employer identification number (EIN):161219829
NAIC Classification:623000
NAIC Description: Nursing and Residential Care Facilities

Form 5500 Filing Information

Submission information for form 5500 for 401k plan LAKEWOOD HEALTH CARE CENTER INC HEALTH INSURANCE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5022012-05-01ROBERT CHUR
5022011-05-01ROBERT CHUR
5022010-05-01ROBERT CHUR
5022009-01-01ROBERT CHUR

Plan Statistics for LAKEWOOD HEALTH CARE CENTER INC HEALTH INSURANCE PLAN

401k plan membership statisitcs for LAKEWOOD HEALTH CARE CENTER INC HEALTH INSURANCE PLAN

Measure Date Value
2012: LAKEWOOD HEALTH CARE CENTER INC HEALTH INSURANCE PLAN 2012 401k membership
Total participants, beginning-of-year2012-05-01134
Total number of active participants reported on line 7a of the Form 55002012-05-01131
Number of retired or separated participants receiving benefits2012-05-011
Total of all active and inactive participants2012-05-01132
Total participants2012-05-01132
Number of participants with account balances2012-05-010
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-05-010
2011: LAKEWOOD HEALTH CARE CENTER INC HEALTH INSURANCE PLAN 2011 401k membership
Total participants, beginning-of-year2011-05-01135
Total number of active participants reported on line 7a of the Form 55002011-05-01125
Number of retired or separated participants receiving benefits2011-05-010
Number of other retired or separated participants entitled to future benefits2011-05-010
Total of all active and inactive participants2011-05-01125
Total participants2011-05-01125
2010: LAKEWOOD HEALTH CARE CENTER INC HEALTH INSURANCE PLAN 2010 401k membership
Total participants, beginning-of-year2010-05-01130
Total number of active participants reported on line 7a of the Form 55002010-05-01130
Number of retired or separated participants receiving benefits2010-05-015
Number of other retired or separated participants entitled to future benefits2010-05-010
Total of all active and inactive participants2010-05-01135
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2010-05-010
Total participants2010-05-01135
Number of participants with account balances2010-05-010
2009: LAKEWOOD HEALTH CARE CENTER INC HEALTH INSURANCE PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-01124
Total number of active participants reported on line 7a of the Form 55002009-01-01131
Number of retired or separated participants receiving benefits2009-01-013
Number of other retired or separated participants entitled to future benefits2009-01-010
Total of all active and inactive participants2009-01-01134
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2009-01-010
Total participants2009-01-01134
Number of participants with account balances2009-01-010
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2009-01-010

Form 5500 Responses for LAKEWOOD HEALTH CARE CENTER INC HEALTH INSURANCE PLAN

2012: LAKEWOOD HEALTH CARE CENTER INC HEALTH INSURANCE PLAN 2012 form 5500 responses
2012-05-01Type of plan entitySingle employer plan
2012-05-01First time form 5500 has been submittedYes
2012-05-01Submission has been amendedNo
2012-05-01This submission is the final filingNo
2012-05-01This return/report is a short plan year return/report (less than 12 months)No
2012-05-01Plan is a collectively bargained planNo
2012-05-01Plan funding arrangement – InsuranceYes
2012-05-01Plan benefit arrangement – InsuranceYes
2011: LAKEWOOD HEALTH CARE CENTER INC HEALTH INSURANCE PLAN 2011 form 5500 responses
2011-05-01Type of plan entitySingle employer plan
2011-05-01First time form 5500 has been submittedYes
2011-05-01Submission has been amendedNo
2011-05-01This submission is the final filingNo
2011-05-01This return/report is a short plan year return/report (less than 12 months)No
2011-05-01Plan is a collectively bargained planNo
2011-05-01Plan funding arrangement – InsuranceYes
2011-05-01Plan benefit arrangement – InsuranceYes
2010: LAKEWOOD HEALTH CARE CENTER INC HEALTH INSURANCE PLAN 2010 form 5500 responses
2010-05-01Type of plan entitySingle employer plan
2010-05-01First time form 5500 has been submittedYes
2010-05-01Submission has been amendedNo
2010-05-01This submission is the final filingNo
2010-05-01This return/report is a short plan year return/report (less than 12 months)No
2010-05-01Plan is a collectively bargained planNo
2010-05-01Plan funding arrangement – InsuranceYes
2010-05-01Plan benefit arrangement – InsuranceYes
2009: LAKEWOOD HEALTH CARE CENTER INC HEALTH INSURANCE PLAN 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01First time form 5500 has been submittedYes
2009-01-01Submission has been amendedNo
2009-01-01This submission is the final filingNo
2009-01-01This return/report is a short plan year return/report (less than 12 months)No
2009-01-01Plan is a collectively bargained planNo
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

INDEPENDENT HEALTH (National Association of Insurance Commissioners NAIC id number: 47034 )
Policy contract numberB4663K 01
Policy instance 1
Insurance contract or identification numberB4663K 01
Number of Individuals Covered245
Insurance policy start date2012-05-01
Insurance policy end date2013-04-30
Total amount of commissions paid to insurance brokerUSD $18,261
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees18261
Insurance broker organization code?3
Insurance broker nameBROWN AND BROWN OF NEW YORK
INDEPENDENT HEALTH (National Association of Insurance Commissioners NAIC id number: 47034 )
Policy contract numberB4663G 03
Policy instance 1
Insurance contract or identification numberB4663G 03
Number of Individuals Covered239
Insurance policy start date2011-05-01
Insurance policy end date2012-04-30
Total amount of commissions paid to insurance brokerUSD $34,273
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
INDEPENDENT HEALTH (National Association of Insurance Commissioners NAIC id number: 47034 )
Policy contract numberB4663G
Policy instance 1
Insurance contract or identification numberB4663G
Number of Individuals Covered222
Insurance policy start date2010-05-01
Insurance policy end date2011-04-30
Total amount of commissions paid to insurance brokerUSD $27,276
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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