401k Plan data: EASTER SEALS JOLIET REGION WELFARE BENEFIT PLAN plan

EASTER SEALS JOLIET REGION WELFARE BENEFIT PLAN 401k Plan overview

Plan Name	EASTER SEALS JOLIET REGION WELFARE BENEFIT PLAN
Plan identification number	501

EASTER SEALS JOLIET REGION WELFARE BENEFIT PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Life insurance Long-term disability cover Other welfare benefit cover

401k Sponsoring company profile

EASTER SEALS JOLIET REGION, INC. has sponsored the creation of one or more 401k plans.

Company Name: EASTER SEALS JOLIET REGION, INC.

Employer identification number (EIN): 362300706

NAIC Classification: 624100
NAIC Description: Individual and Family Services

Form 5500 Filing Information

Submission information for form 5500 for 401k plan EASTER SEALS JOLIET REGION WELFARE BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2020-08-01
501 2020-08-01
501 2019-08-01
501 2018-08-01
501 2017-08-01 DAVID GARDNER DAVID GARDNER 2019-03-04
501 2016-08-01 DAVID GARDNER DAVID GARDNER 2018-03-05

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
501	2020-08-01
501	2020-08-01
501	2019-08-01
501	2018-08-01
501	2017-08-01	DAVID GARDNER	DAVID GARDNER	2019-03-04
501	2016-08-01	DAVID GARDNER	DAVID GARDNER	2018-03-05

Plan Statistics for EASTER SEALS JOLIET REGION WELFARE BENEFIT PLAN

401k plan membership statisitcs for EASTER SEALS JOLIET REGION WELFARE BENEFIT PLAN

Measure Date Value
2020: EASTER SEALS JOLIET REGION WELFARE BENEFIT PLAN 2020 401k membership
Total participants, beginning-of-year 2020-08-01 127
Total number of active participants reported on line 7a of the Form 5500 2020-08-01 118
Number of retired or separated participants receiving benefits 2020-08-01 0
Number of other retired or separated participants entitled to future benefits 2020-08-01 0
Total of all active and inactive participants 2020-08-01 118
2019: EASTER SEALS JOLIET REGION WELFARE BENEFIT PLAN 2019 401k membership
Total participants, beginning-of-year 2019-08-01 130
Total number of active participants reported on line 7a of the Form 5500 2019-08-01 127
Number of retired or separated participants receiving benefits 2019-08-01 0
Number of other retired or separated participants entitled to future benefits 2019-08-01 0
Total of all active and inactive participants 2019-08-01 127
2018: EASTER SEALS JOLIET REGION WELFARE BENEFIT PLAN 2018 401k membership
Total participants, beginning-of-year 2018-08-01 125
Total number of active participants reported on line 7a of the Form 5500 2018-08-01 130
Number of retired or separated participants receiving benefits 2018-08-01 0
Number of other retired or separated participants entitled to future benefits 2018-08-01 0
Total of all active and inactive participants 2018-08-01 130
2017: EASTER SEALS JOLIET REGION WELFARE BENEFIT PLAN 2017 401k membership
Total participants, beginning-of-year 2017-08-01 119
Total number of active participants reported on line 7a of the Form 5500 2017-08-01 125
Total of all active and inactive participants 2017-08-01 125
Total participants 2017-08-01 125
2016: EASTER SEALS JOLIET REGION WELFARE BENEFIT PLAN 2016 401k membership
Total participants, beginning-of-year 2016-08-01 115
Total number of active participants reported on line 7a of the Form 5500 2016-08-01 119
Number of retired or separated participants receiving benefits 2016-08-01 0
Number of other retired or separated participants entitled to future benefits 2016-08-01 0
Total of all active and inactive participants 2016-08-01 119
Total participants 2016-08-01 119

Measure	Date	Value
2020: EASTER SEALS JOLIET REGION WELFARE BENEFIT PLAN 2020 401k membership
Total participants, beginning-of-year	2020-08-01	127
Total number of active participants reported on line 7a of the Form 5500	2020-08-01	118
Number of retired or separated participants receiving benefits	2020-08-01	0
Number of other retired or separated participants entitled to future benefits	2020-08-01	0
Total of all active and inactive participants	2020-08-01	118
2019: EASTER SEALS JOLIET REGION WELFARE BENEFIT PLAN 2019 401k membership
Total participants, beginning-of-year	2019-08-01	130
Total number of active participants reported on line 7a of the Form 5500	2019-08-01	127
Number of retired or separated participants receiving benefits	2019-08-01	0
Number of other retired or separated participants entitled to future benefits	2019-08-01	0
Total of all active and inactive participants	2019-08-01	127
2018: EASTER SEALS JOLIET REGION WELFARE BENEFIT PLAN 2018 401k membership
Total participants, beginning-of-year	2018-08-01	125
Total number of active participants reported on line 7a of the Form 5500	2018-08-01	130
Number of retired or separated participants receiving benefits	2018-08-01	0
Number of other retired or separated participants entitled to future benefits	2018-08-01	0
Total of all active and inactive participants	2018-08-01	130
2017: EASTER SEALS JOLIET REGION WELFARE BENEFIT PLAN 2017 401k membership
Total participants, beginning-of-year	2017-08-01	119
Total number of active participants reported on line 7a of the Form 5500	2017-08-01	125
Total of all active and inactive participants	2017-08-01	125
Total participants	2017-08-01	125
2016: EASTER SEALS JOLIET REGION WELFARE BENEFIT PLAN 2016 401k membership
Total participants, beginning-of-year	2016-08-01	115
Total number of active participants reported on line 7a of the Form 5500	2016-08-01	119
Number of retired or separated participants receiving benefits	2016-08-01	0
Number of other retired or separated participants entitled to future benefits	2016-08-01	0
Total of all active and inactive participants	2016-08-01	119
Total participants	2016-08-01	119

Form 5500 Responses for EASTER SEALS JOLIET REGION WELFARE BENEFIT PLAN

2020: EASTER SEALS JOLIET REGION WELFARE BENEFIT PLAN 2020 form 5500 responses
2020-08-01	Type of plan entity	Single employer plan
2020-08-01	Submission has been amended	No
2020-08-01	This submission is the final filing	No
2020-08-01	This return/report is a short plan year return/report (less than 12 months)	No
2020-08-01	Plan is a collectively bargained plan	No
2020-08-01	Plan funding arrangement – Insurance	Yes
2020-08-01	Plan benefit arrangement – Insurance	Yes
2019: EASTER SEALS JOLIET REGION WELFARE BENEFIT PLAN 2019 form 5500 responses
2019-08-01	Type of plan entity	Single employer plan
2019-08-01	Submission has been amended	No
2019-08-01	This submission is the final filing	No
2019-08-01	This return/report is a short plan year return/report (less than 12 months)	No
2019-08-01	Plan is a collectively bargained plan	No
2019-08-01	Plan funding arrangement – Insurance	Yes
2019-08-01	Plan benefit arrangement – Insurance	Yes
2018: EASTER SEALS JOLIET REGION WELFARE BENEFIT PLAN 2018 form 5500 responses
2018-08-01	Type of plan entity	Single employer plan
2018-08-01	Submission has been amended	No
2018-08-01	This submission is the final filing	No
2018-08-01	This return/report is a short plan year return/report (less than 12 months)	No
2018-08-01	Plan is a collectively bargained plan	No
2018-08-01	Plan funding arrangement – Insurance	Yes
2018-08-01	Plan benefit arrangement – Insurance	Yes
2017: EASTER SEALS JOLIET REGION WELFARE BENEFIT PLAN 2017 form 5500 responses
2017-08-01	Type of plan entity	Single employer plan
2017-08-01	Submission has been amended	No
2017-08-01	This submission is the final filing	No
2017-08-01	This return/report is a short plan year return/report (less than 12 months)	No
2017-08-01	Plan is a collectively bargained plan	No
2017-08-01	Plan funding arrangement – Insurance	Yes
2017-08-01	Plan benefit arrangement – Insurance	Yes
2016: EASTER SEALS JOLIET REGION WELFARE BENEFIT PLAN 2016 form 5500 responses
2016-08-01	Type of plan entity	Single employer plan
2016-08-01	First time form 5500 has been submitted	Yes
2016-08-01	Submission has been amended	No
2016-08-01	This submission is the final filing	No
2016-08-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-08-01	Plan is a collectively bargained plan	No
2016-08-01	Plan funding arrangement – Insurance	Yes
2016-08-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )

Policy contract number

888672G

Policy instance

Insurance contract or identification number	888672G
Number of Individuals Covered	118
Insurance policy start date	2020-08-01
Insurance policy end date	2021-07-31
Total amount of commissions paid to insurance broker	USD $3,287
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	Yes
Unemployment Insurance Welfare Benefit	No
Other welfare benefits provided	ACCIDENTAL DEATH & DISMEMBERMENT
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Welfare Benefit Premiums Paid to Carrier	USD $21,913
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $3,287
Insurance broker organization code?	3

DELTA DENTAL OF ILLINOIS (National Association of Insurance Commissioners NAIC id number: 47589 )

Policy contract number

10085

Policy instance

Insurance contract or identification number	10085
Number of Individuals Covered	77
Insurance policy start date	2020-08-01
Insurance policy end date	2021-07-31
Total amount of commissions paid to insurance broker	USD $1,833
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Welfare Benefit Premiums Paid to Carrier	USD $31,189
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,833
Insurance broker organization code?	3

BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )

Policy contract number

B44436 P45719

Policy instance

Insurance contract or identification number	B44436 P45719
Number of Individuals Covered	95
Insurance policy start date	2020-08-01
Insurance policy end date	2021-07-31
Total amount of commissions paid to insurance broker	USD $32,397
Total amount of fees paid to insurance company	USD $2,175
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	Yes
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Welfare Benefit Premiums Paid to Carrier	USD $832,903
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $32,397
Amount paid for insurance broker fees	2175
Additional information about fees paid to insurance broker	SPECIAL PROGRAMS
Insurance broker organization code?	3

HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )

Policy contract number

888672G

Policy instance

Insurance contract or identification number	888672G
Number of Individuals Covered	127
Insurance policy start date	2019-08-01
Insurance policy end date	2020-07-31
Total amount of commissions paid to insurance broker	USD $3,273
Total amount of fees paid to insurance company	USD $0
Life Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Other welfare benefits provided	ACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to Carrier	USD $21,817
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $3,273
Insurance broker organization code?	3

UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )

Policy contract number

657233

Policy instance

Insurance contract or identification number	657233
Number of Individuals Covered	130
Insurance policy start date	2018-08-01
Insurance policy end date	2019-07-31
Total amount of commissions paid to insurance broker	USD $2,572
Total amount of fees paid to insurance company	USD $354
Life Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Other welfare benefits provided	ACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to Carrier	USD $18,512
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,572
Amount paid for insurance broker fees	354
Additional information about fees paid to insurance broker	ADDITIONAL COMPENSATION PAID
Insurance broker organization code?	3

UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )

Policy contract number

657233

Policy instance

Insurance contract or identification number	657233
Number of Individuals Covered	125
Insurance policy start date	2017-08-01
Insurance policy end date	2018-08-01
Total amount of commissions paid to insurance broker	USD $2,751
Total amount of fees paid to insurance company	USD $742
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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Company Name:	EASTER SEALS JOLIET REGION, INC.
Employer identification number (EIN):	362300706
NAIC Classification:	624100
NAIC Description:	Individual and Family Services