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WOODLANDS SENIOR LIVING, LLC EMPLOYEE GROUP MEDICAL PLAN 401k Plan overview

Plan NameWOODLANDS SENIOR LIVING, LLC EMPLOYEE GROUP MEDICAL PLAN
Plan identification number 501

WOODLANDS SENIOR LIVING, LLC EMPLOYEE GROUP MEDICAL PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Unfunded, fully insured, or combination unfunded/insured welfare plan that will not file a Form 5500 for next plan year pursuant to 29 CFR 2520.104-20.
  • Unfunded, fully insured, or combination unfunded/insured welfare plan that stopped filing form 5500s in an earlier plan year pursuant to 29 CFR 2520.104-20.

401k Sponsoring company profile

WOODLANDS SENIOR LIVING, LLC has sponsored the creation of one or more 401k plans.

Company Name:WOODLANDS SENIOR LIVING, LLC
Employer identification number (EIN):010546232
NAIC Classification:623000
NAIC Description: Nursing and Residential Care Facilities

Form 5500 Filing Information

Submission information for form 5500 for 401k plan WOODLANDS SENIOR LIVING, LLC EMPLOYEE GROUP MEDICAL PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012020-04-01MATTHEW WALTERS2021-10-10
5012019-04-01MATTHEW WALTERS2020-12-21
5012018-04-01MATTHEW WALTERS2020-12-21
5012017-04-01MATTHEW WALTERS2020-12-21
5012016-04-01 ELIZABETH AVERY2020-12-23
5012013-04-01MATTHEW WALTERS2020-12-21

Plan Statistics for WOODLANDS SENIOR LIVING, LLC EMPLOYEE GROUP MEDICAL PLAN

401k plan membership statisitcs for WOODLANDS SENIOR LIVING, LLC EMPLOYEE GROUP MEDICAL PLAN

Measure Date Value
2020: WOODLANDS SENIOR LIVING, LLC EMPLOYEE GROUP MEDICAL PLAN 2020 401k membership
Total participants, beginning-of-year2020-04-01111
Total number of active participants reported on line 7a of the Form 55002020-04-010
Total of all active and inactive participants2020-04-010
2019: WOODLANDS SENIOR LIVING, LLC EMPLOYEE GROUP MEDICAL PLAN 2019 401k membership
Total participants, beginning-of-year2019-04-01131
Total number of active participants reported on line 7a of the Form 55002019-04-01133
Total of all active and inactive participants2019-04-01133
2018: WOODLANDS SENIOR LIVING, LLC EMPLOYEE GROUP MEDICAL PLAN 2018 401k membership
Total participants, beginning-of-year2018-04-01138
Total number of active participants reported on line 7a of the Form 55002018-04-01140
Total of all active and inactive participants2018-04-01140
2017: WOODLANDS SENIOR LIVING, LLC EMPLOYEE GROUP MEDICAL PLAN 2017 401k membership
Total participants, beginning-of-year2017-04-01120
Total number of active participants reported on line 7a of the Form 55002017-04-01141
Total of all active and inactive participants2017-04-01141
2016: WOODLANDS SENIOR LIVING, LLC EMPLOYEE GROUP MEDICAL PLAN 2016 401k membership
Total participants, beginning-of-year2016-04-01113
Total number of active participants reported on line 7a of the Form 55002016-04-0195
Total of all active and inactive participants2016-04-0195
Total participants2016-04-0195
2013: WOODLANDS SENIOR LIVING, LLC EMPLOYEE GROUP MEDICAL PLAN 2013 401k membership
Total participants, beginning-of-year2013-04-01101
Total number of active participants reported on line 7a of the Form 55002013-04-0182
Total of all active and inactive participants2013-04-0182

Form 5500 Responses for WOODLANDS SENIOR LIVING, LLC EMPLOYEE GROUP MEDICAL PLAN

2020: WOODLANDS SENIOR LIVING, LLC EMPLOYEE GROUP MEDICAL PLAN 2020 form 5500 responses
2020-04-01Type of plan entitySingle employer plan
2020-04-01This submission is the final filingYes
2020-04-01Plan funding arrangement – General assets of the sponsorYes
2020-04-01Plan benefit arrangement – General assets of the sponsorYes
2019: WOODLANDS SENIOR LIVING, LLC EMPLOYEE GROUP MEDICAL PLAN 2019 form 5500 responses
2019-04-01Type of plan entitySingle employer plan
2019-04-01Plan funding arrangement – General assets of the sponsorYes
2019-04-01Plan benefit arrangement – General assets of the sponsorYes
2018: WOODLANDS SENIOR LIVING, LLC EMPLOYEE GROUP MEDICAL PLAN 2018 form 5500 responses
2018-04-01Type of plan entitySingle employer plan
2018-04-01Plan funding arrangement – General assets of the sponsorYes
2018-04-01Plan benefit arrangement – General assets of the sponsorYes
2017: WOODLANDS SENIOR LIVING, LLC EMPLOYEE GROUP MEDICAL PLAN 2017 form 5500 responses
2017-04-01Type of plan entitySingle employer plan
2017-04-01Plan funding arrangement – General assets of the sponsorYes
2017-04-01Plan benefit arrangement – General assets of the sponsorYes
2016: WOODLANDS SENIOR LIVING, LLC EMPLOYEE GROUP MEDICAL PLAN 2016 form 5500 responses
2016-04-01Type of plan entitySingle employer plan
2016-04-01Submission has been amendedNo
2016-04-01This submission is the final filingNo
2016-04-01This return/report is a short plan year return/report (less than 12 months)No
2016-04-01Plan is a collectively bargained planNo
2016-04-01Plan funding arrangement – InsuranceYes
2016-04-01Plan benefit arrangement – InsuranceYes
2013: WOODLANDS SENIOR LIVING, LLC EMPLOYEE GROUP MEDICAL PLAN 2013 form 5500 responses
2013-04-01Type of plan entitySingle employer plan
2013-04-01First time form 5500 has been submittedYes
2013-04-01Plan funding arrangement – InsuranceYes
2013-04-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

HARVARD PILGRIM HEALTH CARE, INC. (National Association of Insurance Commissioners NAIC id number: 96911 )
Policy contract number020278
Policy instance 1
Insurance contract or identification number020278
Number of Individuals Covered89
Insurance policy start date2013-03-01
Insurance policy end date2014-02-28
Total amount of commissions paid to insurance brokerUSD $23,993
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $619,530
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $23,993
Insurance broker organization code?3
HPHC INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 18975 )
Policy contract number020279
Policy instance 2
Insurance contract or identification number020279
Number of Individuals Covered6
Insurance policy start date2013-03-01
Insurance policy end date2014-02-28
Total amount of commissions paid to insurance brokerUSD $1,871
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $48,322
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,871
Insurance broker organization code?3

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