401k Plan data: GROUP LONG-TERM DISABILITY INSURANCE plan

GROUP LONG-TERM DISABILITY INSURANCE 401k Plan overview

Plan Name	GROUP LONG-TERM DISABILITY INSURANCE
Plan identification number	504

GROUP LONG-TERM DISABILITY INSURANCE Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Long-term disability cover

401k Sponsoring company profile

SAMUEL AND ALTHEA STROUM JEWISH COMMUNITY CENTER has sponsored the creation of one or more 401k plans.

Company Name: SAMUEL AND ALTHEA STROUM JEWISH COMMUNITY CENTER

Employer identification number (EIN): 900953408

NAIC Classification: 813000
NAIC Description: Religious, Grantmaking, Civic, Professional, and Similar Organizations

Form 5500 Filing Information

Submission information for form 5500 for 401k plan GROUP LONG-TERM DISABILITY INSURANCE

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
504 2022-09-01
504 2021-09-01

Plan Statistics for GROUP LONG-TERM DISABILITY INSURANCE

401k plan membership statisitcs for GROUP LONG-TERM DISABILITY INSURANCE

Measure Date Value
2022: GROUP LONG-TERM DISABILITY INSURANCE 2022 401k membership
Total participants, beginning-of-year 2022-09-01 107
Total number of active participants reported on line 7a of the Form 5500 2022-09-01 114
Total of all active and inactive participants 2022-09-01 114
Total participants 2022-09-01 114
2021: GROUP LONG-TERM DISABILITY INSURANCE 2021 401k membership
Total participants, beginning-of-year 2021-09-01 107
Total number of active participants reported on line 7a of the Form 5500 2021-09-01 107
Total of all active and inactive participants 2021-09-01 107
Total participants 2021-09-01 107

Measure	Date	Value
2022: GROUP LONG-TERM DISABILITY INSURANCE 2022 401k membership
Total participants, beginning-of-year	2022-09-01	107
Total number of active participants reported on line 7a of the Form 5500	2022-09-01	114
Total of all active and inactive participants	2022-09-01	114
Total participants	2022-09-01	114
2021: GROUP LONG-TERM DISABILITY INSURANCE 2021 401k membership
Total participants, beginning-of-year	2021-09-01	107
Total number of active participants reported on line 7a of the Form 5500	2021-09-01	107
Total of all active and inactive participants	2021-09-01	107
Total participants	2021-09-01	107

Form 5500 Responses for GROUP LONG-TERM DISABILITY INSURANCE

2022: GROUP LONG-TERM DISABILITY INSURANCE 2022 form 5500 responses
2022-09-01	Type of plan entity	Single employer plan
2022-09-01	Submission has been amended	No
2022-09-01	This submission is the final filing	No
2022-09-01	This return/report is a short plan year return/report (less than 12 months)	No
2022-09-01	Plan is a collectively bargained plan	No
2022-09-01	Plan funding arrangement – Insurance	Yes
2022-09-01	Plan benefit arrangement – Insurance	Yes
2021: GROUP LONG-TERM DISABILITY INSURANCE 2021 form 5500 responses
2021-09-01	Type of plan entity	Single employer plan
2021-09-01	First time form 5500 has been submitted	Yes
2021-09-01	Submission has been amended	No
2021-09-01	This submission is the final filing	No
2021-09-01	This return/report is a short plan year return/report (less than 12 months)	No
2021-09-01	Plan is a collectively bargained plan	No
2021-09-01	Plan funding arrangement – Insurance	Yes
2021-09-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )

Policy contract number

LTD 132024

Policy instance

Insurance contract or identification number	LTD 132024
Number of Individuals Covered	114
Insurance policy start date	2022-09-01
Insurance policy end date	2023-08-31
Total amount of commissions paid to insurance broker	USD $1,233
Total amount of fees paid to insurance company	USD $1
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	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	Yes
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 $8,219
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,233
Amount paid for insurance broker fees	1
Insurance broker organization code?	3

RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )

Policy contract number

132024

Policy instance

Insurance contract or identification number	132024
Number of Individuals Covered	107
Insurance policy start date	2021-09-01
Insurance policy end date	2022-08-31
Total amount of commissions paid to insurance broker	USD $1,131
Total amount of fees paid to insurance company	USD $118
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	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	Yes
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 $7,539
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,131
Amount paid for insurance broker fees	118
Insurance broker organization code?	3

Potentially related plans

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Company Name:	SAMUEL AND ALTHEA STROUM JEWISH COMMUNITY CENTER
Employer identification number (EIN):	900953408
NAIC Classification:	813000
NAIC Description:	Religious, Grantmaking, Civic, Professional, and Similar Organizations