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WESTSIDE CHILDREN'S THERAPY LIFE, AD&D, STD, AND VISION PLAN 401k Plan overview

Plan NameWESTSIDE CHILDREN'S THERAPY LIFE, AD&D, STD, AND VISION PLAN
Plan identification number 503

WESTSIDE CHILDREN'S THERAPY LIFE, AD&D, STD, AND VISION PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Life insurance
  • Vision
  • Temporary disability (accident and sickness)
  • Death benefits (include travel accident but not life insurance)

401k Sponsoring company profile

WESTSIDE CHILDREN'S THERAPY has sponsored the creation of one or more 401k plans.

Company Name:WESTSIDE CHILDREN'S THERAPY
Employer identification number (EIN):261120223
NAIC Classification:621340
NAIC Description:Offices of Physical, Occupational and Speech Therapists, and Audiologists

Form 5500 Filing Information

Submission information for form 5500 for 401k plan WESTSIDE CHILDREN'S THERAPY LIFE, AD&D, STD, AND VISION PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5032023-04-01TIFFANY HASKI2024-05-28
5032022-04-01TIFFANY HASKI2023-10-16
5032021-04-01MARY SPREITZER2022-10-12

Plan Statistics for WESTSIDE CHILDREN'S THERAPY LIFE, AD&D, STD, AND VISION PLAN

401k plan membership statisitcs for WESTSIDE CHILDREN'S THERAPY LIFE, AD&D, STD, AND VISION PLAN

Measure Date Value
2023: WESTSIDE CHILDREN'S THERAPY LIFE, AD&D, STD, AND VISION PLAN 2023 401k membership
Total participants, beginning-of-year2023-04-01517
Total number of active participants reported on line 7a of the Form 55002023-04-01633
Number of retired or separated participants receiving benefits2023-04-010
Number of other retired or separated participants entitled to future benefits2023-04-010
Total of all active and inactive participants2023-04-01633
Number of employers contributing to the scheme2023-04-010
2022: WESTSIDE CHILDREN'S THERAPY LIFE, AD&D, STD, AND VISION PLAN 2022 401k membership
Total participants, beginning-of-year2022-04-01412
Total number of active participants reported on line 7a of the Form 55002022-04-01517
Number of retired or separated participants receiving benefits2022-04-010
Number of other retired or separated participants entitled to future benefits2022-04-010
Total of all active and inactive participants2022-04-01517
Number of employers contributing to the scheme2022-04-010
2021: WESTSIDE CHILDREN'S THERAPY LIFE, AD&D, STD, AND VISION PLAN 2021 401k membership
Total participants, beginning-of-year2021-04-01175
Total number of active participants reported on line 7a of the Form 55002021-04-01176
Number of retired or separated participants receiving benefits2021-04-010
Number of other retired or separated participants entitled to future benefits2021-04-010
Total of all active and inactive participants2021-04-01176
Number of employers contributing to the scheme2021-04-010

Form 5500 Responses for WESTSIDE CHILDREN'S THERAPY LIFE, AD&D, STD, AND VISION PLAN

2023: WESTSIDE CHILDREN'S THERAPY LIFE, AD&D, STD, AND VISION PLAN 2023 form 5500 responses
2023-04-01Type of plan entitySingle employer plan
2023-04-01This return/report is a short plan year return/report (less than 12 months)Yes
2023-04-01Plan funding arrangement – InsuranceYes
2023-04-01Plan benefit arrangement – InsuranceYes
2022: WESTSIDE CHILDREN'S THERAPY LIFE, AD&D, STD, AND VISION PLAN 2022 form 5500 responses
2022-04-01Type of plan entitySingle employer plan
2022-04-01Plan funding arrangement – InsuranceYes
2022-04-01Plan benefit arrangement – InsuranceYes
2021: WESTSIDE CHILDREN'S THERAPY LIFE, AD&D, STD, AND VISION PLAN 2021 form 5500 responses
2021-04-01Type of plan entitySingle employer plan
2021-04-01First time form 5500 has been submittedYes
2021-04-01Plan funding arrangement – InsuranceYes
2021-04-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract numberF022481
Policy instance 1
Insurance contract or identification numberF022481
Number of Individuals Covered635
Insurance policy start date2023-04-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $21,708
Total amount of fees paid to insurance companyUSD $2,141
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $144,879
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract numberF022481
Policy instance 1
Insurance contract or identification numberF022481
Number of Individuals Covered503
Insurance policy start date2022-04-01
Insurance policy end date2023-03-31
Total amount of commissions paid to insurance brokerUSD $15,241
Total amount of fees paid to insurance companyUSD $1,806
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $103,019
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $15,241
Amount paid for insurance broker fees1806
Additional information about fees paid to insurance brokerADDITIONAL COMPENSATION
Insurance broker organization code?3
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract numberF022481
Policy instance 1
Insurance contract or identification numberF022481
Number of Individuals Covered413
Insurance policy start date2021-04-01
Insurance policy end date2022-03-31
Total amount of commissions paid to insurance brokerUSD $11,752
Total amount of fees paid to insurance companyUSD $1,150
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $77,181
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $11,752
Amount paid for insurance broker fees1150
Additional information about fees paid to insurance brokerADDITIONAL COMPENSATION
Insurance broker organization code?3

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