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LIFE INSURANCE PLAN FOR THE EMPLOYEES OF HILO MEDICAL INVESTORS LTD. 401k Plan overview

Plan NameLIFE INSURANCE PLAN FOR THE EMPLOYEES OF HILO MEDICAL INVESTORS LTD.
Plan identification number 501

LIFE INSURANCE PLAN FOR THE EMPLOYEES OF HILO MEDICAL INVESTORS LTD. Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Life insurance
  • Other welfare benefit cover

401k Sponsoring company profile

HILO MEDICAL INVESTORS, LTD DBA LIFE CARE CENTER OF HILO AND has sponsored the creation of one or more 401k plans.

Company Name:HILO MEDICAL INVESTORS, LTD DBA LIFE CARE CENTER OF HILO AND
Employer identification number (EIN):581339022
NAIC Classification:623000
NAIC Description: Nursing and Residential Care Facilities

Form 5500 Filing Information

Submission information for form 5500 for 401k plan LIFE INSURANCE PLAN FOR THE EMPLOYEES OF HILO MEDICAL INVESTORS LTD.

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012023-01-01TERRY HENRY2024-08-28
5012022-01-01MARK MANN2023-10-13
5012021-01-01LORETA WHITNEY2022-10-12
5012020-01-01JAY BEAUDOIN2021-10-19
5012019-01-01BETH WILLIAMS2020-10-15
5012018-01-01BETH WILLIAMS2019-10-14
5012017-01-01
5012016-01-01
5012015-01-01
5012014-01-01
5012013-01-01
5012012-01-01FRED D. HORWITZ
5012011-01-01FRED D. HORWITZ
5012009-01-01TERRY HENRY

Plan Statistics for LIFE INSURANCE PLAN FOR THE EMPLOYEES OF HILO MEDICAL INVESTORS LTD.

401k plan membership statisitcs for LIFE INSURANCE PLAN FOR THE EMPLOYEES OF HILO MEDICAL INVESTORS LTD.

Measure Date Value
2023: LIFE INSURANCE PLAN FOR THE EMPLOYEES OF HILO MEDICAL INVESTORS LTD. 2023 401k membership
Total participants, beginning-of-year2023-01-01271
Total number of active participants reported on line 7a of the Form 55002023-01-01303
Number of retired or separated participants receiving benefits2023-01-010
Number of other retired or separated participants entitled to future benefits2023-01-010
Total of all active and inactive participants2023-01-01303
2022: LIFE INSURANCE PLAN FOR THE EMPLOYEES OF HILO MEDICAL INVESTORS LTD. 2022 401k membership
Total participants, beginning-of-year2022-01-01301
Total number of active participants reported on line 7a of the Form 55002022-01-01271
Number of retired or separated participants receiving benefits2022-01-010
Number of other retired or separated participants entitled to future benefits2022-01-010
Total of all active and inactive participants2022-01-01271
2021: LIFE INSURANCE PLAN FOR THE EMPLOYEES OF HILO MEDICAL INVESTORS LTD. 2021 401k membership
Total participants, beginning-of-year2021-01-01322
Total number of active participants reported on line 7a of the Form 55002021-01-01301
Number of retired or separated participants receiving benefits2021-01-010
Number of other retired or separated participants entitled to future benefits2021-01-010
Total of all active and inactive participants2021-01-01301
2020: LIFE INSURANCE PLAN FOR THE EMPLOYEES OF HILO MEDICAL INVESTORS LTD. 2020 401k membership
Total participants, beginning-of-year2020-01-01352
Total number of active participants reported on line 7a of the Form 55002020-01-01322
Number of retired or separated participants receiving benefits2020-01-010
Number of other retired or separated participants entitled to future benefits2020-01-010
Total of all active and inactive participants2020-01-01322
2019: LIFE INSURANCE PLAN FOR THE EMPLOYEES OF HILO MEDICAL INVESTORS LTD. 2019 401k membership
Total participants, beginning-of-year2019-01-01356
Total number of active participants reported on line 7a of the Form 55002019-01-01352
Number of retired or separated participants receiving benefits2019-01-010
Number of other retired or separated participants entitled to future benefits2019-01-010
Total of all active and inactive participants2019-01-01352
2018: LIFE INSURANCE PLAN FOR THE EMPLOYEES OF HILO MEDICAL INVESTORS LTD. 2018 401k membership
Total participants, beginning-of-year2018-01-01381
Total number of active participants reported on line 7a of the Form 55002018-01-01356
Number of retired or separated participants receiving benefits2018-01-010
Number of other retired or separated participants entitled to future benefits2018-01-010
Total of all active and inactive participants2018-01-01356
2017: LIFE INSURANCE PLAN FOR THE EMPLOYEES OF HILO MEDICAL INVESTORS LTD. 2017 401k membership
Total participants, beginning-of-year2017-01-01339
Total number of active participants reported on line 7a of the Form 55002017-01-01381
Number of retired or separated participants receiving benefits2017-01-010
Number of other retired or separated participants entitled to future benefits2017-01-010
Total of all active and inactive participants2017-01-01381
2016: LIFE INSURANCE PLAN FOR THE EMPLOYEES OF HILO MEDICAL INVESTORS LTD. 2016 401k membership
Total participants, beginning-of-year2016-01-01392
Total number of active participants reported on line 7a of the Form 55002016-01-01339
Number of retired or separated participants receiving benefits2016-01-010
Number of other retired or separated participants entitled to future benefits2016-01-0145
Total of all active and inactive participants2016-01-01384
2015: LIFE INSURANCE PLAN FOR THE EMPLOYEES OF HILO MEDICAL INVESTORS LTD. 2015 401k membership
Total participants, beginning-of-year2015-01-01402
Total number of active participants reported on line 7a of the Form 55002015-01-01392
Total of all active and inactive participants2015-01-01392
2014: LIFE INSURANCE PLAN FOR THE EMPLOYEES OF HILO MEDICAL INVESTORS LTD. 2014 401k membership
Total participants, beginning-of-year2014-01-01389
Total number of active participants reported on line 7a of the Form 55002014-01-01402
Total of all active and inactive participants2014-01-01402
2013: LIFE INSURANCE PLAN FOR THE EMPLOYEES OF HILO MEDICAL INVESTORS LTD. 2013 401k membership
Total participants, beginning-of-year2013-01-01380
Total number of active participants reported on line 7a of the Form 55002013-01-01389
Total of all active and inactive participants2013-01-01389
2012: LIFE INSURANCE PLAN FOR THE EMPLOYEES OF HILO MEDICAL INVESTORS LTD. 2012 401k membership
Total participants, beginning-of-year2012-01-01381
Total number of active participants reported on line 7a of the Form 55002012-01-01380
Total of all active and inactive participants2012-01-01380
2011: LIFE INSURANCE PLAN FOR THE EMPLOYEES OF HILO MEDICAL INVESTORS LTD. 2011 401k membership
Total participants, beginning-of-year2011-01-01366
Total number of active participants reported on line 7a of the Form 55002011-01-01381
Total of all active and inactive participants2011-01-01381
2009: LIFE INSURANCE PLAN FOR THE EMPLOYEES OF HILO MEDICAL INVESTORS LTD. 2009 401k membership
Total participants, beginning-of-year2009-01-01326
Total number of active participants reported on line 7a of the Form 55002009-01-01376
Number of retired or separated participants receiving benefits2009-01-010
Number of other retired or separated participants entitled to future benefits2009-01-010
Total of all active and inactive participants2009-01-01376

Form 5500 Responses for LIFE INSURANCE PLAN FOR THE EMPLOYEES OF HILO MEDICAL INVESTORS LTD.

2023: LIFE INSURANCE PLAN FOR THE EMPLOYEES OF HILO MEDICAL INVESTORS LTD. 2023 form 5500 responses
2023-01-01Type of plan entitySingle employer plan
2023-01-01Submission has been amendedNo
2023-01-01This submission is the final filingNo
2023-01-01This return/report is a short plan year return/report (less than 12 months)No
2023-01-01Plan is a collectively bargained planNo
2023-01-01Plan funding arrangement – InsuranceYes
2023-01-01Plan funding arrangement – General assets of the sponsorYes
2023-01-01Plan benefit arrangement – InsuranceYes
2022: LIFE INSURANCE PLAN FOR THE EMPLOYEES OF HILO MEDICAL INVESTORS LTD. 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan funding arrangement – General assets of the sponsorYes
2022-01-01Plan benefit arrangement – InsuranceYes
2021: LIFE INSURANCE PLAN FOR THE EMPLOYEES OF HILO MEDICAL INVESTORS LTD. 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan funding arrangement – General assets of the sponsorYes
2021-01-01Plan benefit arrangement – InsuranceYes
2020: LIFE INSURANCE PLAN FOR THE EMPLOYEES OF HILO MEDICAL INVESTORS LTD. 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan funding arrangement – General assets of the sponsorYes
2020-01-01Plan benefit arrangement – InsuranceYes
2019: LIFE INSURANCE PLAN FOR THE EMPLOYEES OF HILO MEDICAL INVESTORS LTD. 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan funding arrangement – General assets of the sponsorYes
2019-01-01Plan benefit arrangement – InsuranceYes
2018: LIFE INSURANCE PLAN FOR THE EMPLOYEES OF HILO MEDICAL INVESTORS LTD. 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan funding arrangement – General assets of the sponsorYes
2018-01-01Plan benefit arrangement – InsuranceYes
2017: LIFE INSURANCE PLAN FOR THE EMPLOYEES OF HILO MEDICAL INVESTORS LTD. 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan funding arrangement – General assets of the sponsorYes
2017-01-01Plan benefit arrangement – InsuranceYes
2016: LIFE INSURANCE PLAN FOR THE EMPLOYEES OF HILO MEDICAL INVESTORS LTD. 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan funding arrangement – General assets of the sponsorYes
2016-01-01Plan benefit arrangement – InsuranceYes
2015: LIFE INSURANCE PLAN FOR THE EMPLOYEES OF HILO MEDICAL INVESTORS LTD. 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan funding arrangement – General assets of the sponsorYes
2015-01-01Plan benefit arrangement – InsuranceYes
2014: LIFE INSURANCE PLAN FOR THE EMPLOYEES OF HILO MEDICAL INVESTORS LTD. 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan funding arrangement – General assets of the sponsorYes
2014-01-01Plan benefit arrangement – InsuranceYes
2013: LIFE INSURANCE PLAN FOR THE EMPLOYEES OF HILO MEDICAL INVESTORS LTD. 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan funding arrangement – General assets of the sponsorYes
2013-01-01Plan benefit arrangement – InsuranceYes
2012: LIFE INSURANCE PLAN FOR THE EMPLOYEES OF HILO MEDICAL INVESTORS LTD. 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan funding arrangement – General assets of the sponsorYes
2012-01-01Plan benefit arrangement – InsuranceYes
2011: LIFE INSURANCE PLAN FOR THE EMPLOYEES OF HILO MEDICAL INVESTORS LTD. 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan funding arrangement – General assets of the sponsorYes
2011-01-01Plan benefit arrangement – InsuranceYes
2009: LIFE INSURANCE PLAN FOR THE EMPLOYEES OF HILO MEDICAL INVESTORS LTD. 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01This submission is the final filingNo
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan funding arrangement – General assets of the sponsorYes
2009-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

PACIFIC GUARDIAN LIFE INSURANCE COMPANY, LTD. (National Association of Insurance Commissioners NAIC id number: 64343 )
Policy contract number40360-101
Policy instance 1
Insurance contract or identification number40360-101
Number of Individuals Covered91
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $171
Total amount of fees paid to insurance companyUSD $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 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 BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedAD&D
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 $1,427
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PACIFIC GUARDIAN LIFE INSURANCE COMPANY, LTD. (National Association of Insurance Commissioners NAIC id number: 64343 )
Policy contract number40360-102
Policy instance 2
Insurance contract or identification number40360-102
Number of Individuals Covered212
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $528
Total amount of fees paid to insurance companyUSD $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 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 BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedAD&D
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 $4,403
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PACIFIC GUARDIAN LIFE INSURANCE COMPANY, LTD. (National Association of Insurance Commissioners NAIC id number: 64343 )
Policy contract number40360-101
Policy instance 1
Insurance contract or identification number40360-101
Number of Individuals Covered83
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $158
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $1,312
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $158
Amount paid for insurance broker fees0
Insurance broker organization code?3
PACIFIC GUARDIAN LIFE INSURANCE COMPANY, LTD. (National Association of Insurance Commissioners NAIC id number: 64343 )
Policy contract number40360-102
Policy instance 2
Insurance contract or identification number40360-102
Number of Individuals Covered188
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $275
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $2,291
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $275
Amount paid for insurance broker fees0
Insurance broker organization code?3
PACIFIC GUARDIAN LIFE INSURANCE COMPANY, LTD. (National Association of Insurance Commissioners NAIC id number: 64343 )
Policy contract number40360
Policy instance 1
Insurance contract or identification number40360
Number of Individuals Covered301
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $517
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $4,304
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $517
Amount paid for insurance broker fees0
Insurance broker organization code?3
PACIFIC GUARDIAN LIFE INSURANCE COMPANY, LTD. (National Association of Insurance Commissioners NAIC id number: 64343 )
Policy contract number40360
Policy instance 1
Insurance contract or identification number40360
Number of Individuals Covered322
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $605
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $5,038
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $605
Amount paid for insurance broker fees0
Insurance broker organization code?3
PACIFIC GUARDIAN LIFE INSURANCE COMPANY, LTD. (National Association of Insurance Commissioners NAIC id number: 64343 )
Policy contract number40360
Policy instance 1
Insurance contract or identification number40360
Number of Individuals Covered352
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $634
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $5,287
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $634
Amount paid for insurance broker fees0
Insurance broker organization code?3
PACIFIC GUARDIAN LIFE INSURANCE COMPANY, LTD. (National Association of Insurance Commissioners NAIC id number: 64343 )
Policy contract number40360
Policy instance 1
Insurance contract or identification number40360
Number of Individuals Covered356
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $634
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $5,287
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $634
Amount paid for insurance broker fees0
Insurance broker organization code?3
PACIFIC GUARDIAN LIFE INSURANCE COMPANY, LTD. (National Association of Insurance Commissioners NAIC id number: 64343 )
Policy contract number40360
Policy instance 1
Insurance contract or identification number40360
Number of Individuals Covered381
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $636
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $5,300
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $561
Amount paid for insurance broker fees0
Insurance broker organization code?3
Insurance broker nameSERVCO INS SVCS, ATTN ROBERTSON RUS

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