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FOUR SEASONS NURSING AND REHABILITATION 401k Plan overview

Plan NameFOUR SEASONS NURSING AND REHABILITATION
Plan identification number 501

FOUR SEASONS NURSING AND REHABILITATION Benefits

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

401k Sponsoring company profile

FOUR SEASONS NURSING AND REHABILITATION has sponsored the creation of one or more 401k plans.

Company Name:FOUR SEASONS NURSING AND REHABILITATION
Employer identification number (EIN):522360831
NAIC Classification:623000
NAIC Description: Nursing and Residential Care Facilities

Form 5500 Filing Information

Submission information for form 5500 for 401k plan FOUR SEASONS NURSING AND REHABILITATION

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012020-07-01
5012019-07-01
5012018-07-01
5012017-07-01JEFF GOLDSTEIN JEFF GOLDSTEIN2019-03-20

Plan Statistics for FOUR SEASONS NURSING AND REHABILITATION

401k plan membership statisitcs for FOUR SEASONS NURSING AND REHABILITATION

Measure Date Value
2020: FOUR SEASONS NURSING AND REHABILITATION 2020 401k membership
Total participants, beginning-of-year2020-07-01107
Total number of active participants reported on line 7a of the Form 55002020-07-01114
Number of retired or separated participants receiving benefits2020-07-010
Total of all active and inactive participants2020-07-01114
Total participants2020-07-01114
2019: FOUR SEASONS NURSING AND REHABILITATION 2019 401k membership
Total participants, beginning-of-year2019-07-01161
Total number of active participants reported on line 7a of the Form 55002019-07-01106
Number of retired or separated participants receiving benefits2019-07-011
Total of all active and inactive participants2019-07-01107
Total participants2019-07-01107
2018: FOUR SEASONS NURSING AND REHABILITATION 2018 401k membership
Total participants, beginning-of-year2018-07-01172
Total number of active participants reported on line 7a of the Form 55002018-07-01160
Number of retired or separated participants receiving benefits2018-07-011
Total of all active and inactive participants2018-07-01161
Total participants2018-07-01161
2017: FOUR SEASONS NURSING AND REHABILITATION 2017 401k membership
Total participants, beginning-of-year2017-07-01189
Total number of active participants reported on line 7a of the Form 55002017-07-01169
Number of retired or separated participants receiving benefits2017-07-013
Total of all active and inactive participants2017-07-01172
Total participants2017-07-01172

Form 5500 Responses for FOUR SEASONS NURSING AND REHABILITATION

2020: FOUR SEASONS NURSING AND REHABILITATION 2020 form 5500 responses
2020-07-01Type of plan entitySingle employer plan
2020-07-01Submission has been amendedNo
2020-07-01This submission is the final filingNo
2020-07-01This return/report is a short plan year return/report (less than 12 months)Yes
2020-07-01Plan is a collectively bargained planNo
2020-07-01Plan funding arrangement – General assets of the sponsorYes
2020-07-01Plan benefit arrangement – General assets of the sponsorYes
2019: FOUR SEASONS NURSING AND REHABILITATION 2019 form 5500 responses
2019-07-01Type of plan entitySingle employer plan
2019-07-01Submission has been amendedNo
2019-07-01This submission is the final filingNo
2019-07-01This return/report is a short plan year return/report (less than 12 months)No
2019-07-01Plan is a collectively bargained planNo
2019-07-01Plan funding arrangement – General assets of the sponsorYes
2019-07-01Plan benefit arrangement – General assets of the sponsorYes
2018: FOUR SEASONS NURSING AND REHABILITATION 2018 form 5500 responses
2018-07-01Type of plan entitySingle employer plan
2018-07-01Submission has been amendedNo
2018-07-01This submission is the final filingNo
2018-07-01This return/report is a short plan year return/report (less than 12 months)No
2018-07-01Plan is a collectively bargained planNo
2018-07-01Plan funding arrangement – General assets of the sponsorYes
2018-07-01Plan benefit arrangement – General assets of the sponsorYes
2017: FOUR SEASONS NURSING AND REHABILITATION 2017 form 5500 responses
2017-07-01Type of plan entitySingle employer plan
2017-07-01First time form 5500 has been submittedYes
2017-07-01Submission has been amendedNo
2017-07-01This submission is the final filingNo
2017-07-01This return/report is a short plan year return/report (less than 12 months)No
2017-07-01Plan is a collectively bargained planNo
2017-07-01Plan funding arrangement – General assets of the sponsorYes
2017-07-01Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 )
Policy contract numberHCL35237
Policy instance 1
Insurance contract or identification numberHCL35237
Number of Individuals Covered478
Insurance policy start date2019-12-01
Insurance policy end date2020-11-30
Total amount of commissions paid to insurance brokerUSD $45,413
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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 CarrierUSD $454,132
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $45,413
Insurance broker organization code?3
HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 )
Policy contract numberHCL33309
Policy instance 1
Insurance contract or identification numberHCL33309
Number of Individuals Covered164
Insurance policy start date2018-06-01
Insurance policy end date2019-05-31
Total amount of commissions paid to insurance brokerUSD $81,303
Total amount of fees paid to insurance companyUSD $542,021
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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 CarrierUSD $542,021
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $81,303
Insurance broker organization code?3
HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 )
Policy contract numberHC33309
Policy instance 1
Insurance contract or identification numberHC33309
Number of Individuals Covered169
Insurance policy start date2017-07-01
Insurance policy end date2018-06-30
Total amount of commissions paid to insurance brokerUSD $17,818
Total amount of fees paid to insurance companyUSD $118,784
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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 CarrierUSD $118,784
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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