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PETERBOROUGH RETIREMENT COMMUNITY AT UPLAND FARM, INC DBA RIVERMEAD 401k Plan overview

Plan NamePETERBOROUGH RETIREMENT COMMUNITY AT UPLAND FARM, INC DBA RIVERMEAD
Plan identification number 503

PETERBOROUGH RETIREMENT COMMUNITY AT UPLAND FARM, INC DBA RIVERMEAD Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Life insurance
  • Dental
  • Temporary disability (accident and sickness)
  • Long-term disability cover

401k Sponsoring company profile

PETERBOROUGH RETIREMENT COMMUNITY AT UPLAND FARM, INC. has sponsored the creation of one or more 401k plans.

Company Name:PETERBOROUGH RETIREMENT COMMUNITY AT UPLAND FARM, INC.
Employer identification number (EIN):020446675
NAIC Classification:623000
NAIC Description: Nursing and Residential Care Facilities

Form 5500 Filing Information

Submission information for form 5500 for 401k plan PETERBOROUGH RETIREMENT COMMUNITY AT UPLAND FARM, INC DBA RIVERMEAD

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5032018-01-01
5032018-01-01MARTIN JAMES CONLEY III2020-05-07
5032017-01-01BRIAN DONNELLY BRIAN DONNELLY2018-10-05
5032016-01-01BRIAN DONNELLY
5032015-01-01BRIAN DONNELLY

Plan Statistics for PETERBOROUGH RETIREMENT COMMUNITY AT UPLAND FARM, INC DBA RIVERMEAD

401k plan membership statisitcs for PETERBOROUGH RETIREMENT COMMUNITY AT UPLAND FARM, INC DBA RIVERMEAD

Measure Date Value
2018: PETERBOROUGH RETIREMENT COMMUNITY AT UPLAND FARM, INC DBA RIVERMEAD 2018 401k membership
Total participants, beginning-of-year2018-01-01124
Total number of active participants reported on line 7a of the Form 55002018-01-010
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 participants2018-01-010
Number of employers contributing to the scheme2018-01-010
2017: PETERBOROUGH RETIREMENT COMMUNITY AT UPLAND FARM, INC DBA RIVERMEAD 2017 401k membership
Total participants, beginning-of-year2017-01-01122
Total number of active participants reported on line 7a of the Form 55002017-01-01128
Total of all active and inactive participants2017-01-01128
2016: PETERBOROUGH RETIREMENT COMMUNITY AT UPLAND FARM, INC DBA RIVERMEAD 2016 401k membership
Total participants, beginning-of-year2016-01-01119
Total number of active participants reported on line 7a of the Form 55002016-01-01122
Total of all active and inactive participants2016-01-01122
2015: PETERBOROUGH RETIREMENT COMMUNITY AT UPLAND FARM, INC DBA RIVERMEAD 2015 401k membership
Total participants, beginning-of-year2015-01-01123
Total number of active participants reported on line 7a of the Form 55002015-01-01119
Total of all active and inactive participants2015-01-01119

Form 5500 Responses for PETERBOROUGH RETIREMENT COMMUNITY AT UPLAND FARM, INC DBA RIVERMEAD

2018: PETERBOROUGH RETIREMENT COMMUNITY AT UPLAND FARM, INC DBA RIVERMEAD 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Submission has been amendedYes
2018-01-01This submission is the final filingYes
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan benefit arrangement – InsuranceYes
2017: PETERBOROUGH RETIREMENT COMMUNITY AT UPLAND FARM, INC DBA RIVERMEAD 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Submission has been amendedNo
2017-01-01This submission is the final filingNo
2017-01-01This return/report is a short plan year return/report (less than 12 months)No
2017-01-01Plan is a collectively bargained planNo
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan benefit arrangement – InsuranceYes
2016: PETERBOROUGH RETIREMENT COMMUNITY AT UPLAND FARM, INC DBA RIVERMEAD 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Submission has been amendedNo
2016-01-01This submission is the final filingNo
2016-01-01This return/report is a short plan year return/report (less than 12 months)No
2016-01-01Plan is a collectively bargained planNo
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan benefit arrangement – InsuranceYes
2015: PETERBOROUGH RETIREMENT COMMUNITY AT UPLAND FARM, INC DBA RIVERMEAD 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01First time form 5500 has been submittedYes
2015-01-01Submission has been amendedNo
2015-01-01This submission is the final filingNo
2015-01-01This return/report is a short plan year return/report (less than 12 months)No
2015-01-01Plan is a collectively bargained planNo
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

ANTHEM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61069 )
Policy contract numberAL00006166
Policy instance 1
Insurance contract or identification numberAL00006166
Number of Individuals Covered135
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $7,245
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $53,772
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,245
Amount paid for insurance broker fees0
Insurance broker organization code?3
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract numberTM05928722
Policy instance 1
Insurance contract or identification numberTM05928722
Number of Individuals Covered122
Insurance policy start date2017-01-01
Insurance policy end date2017-05-31
Total amount of commissions paid to insurance brokerUSD $2,044
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 BenefitYes
Long Term Disability Insurance Welfare BenefitYes
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 $26,551
Commission paid to Insurance BrokerUSD $2,044
Insurance broker organization code?3
Insurance broker nameINSURANCE PLANNING GROUP INC
ANTHEM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61069 )
Policy contract numberTM05928722
Policy instance 2
Insurance contract or identification numberTM05928722
Number of Individuals Covered128
Insurance policy start date2017-06-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $3,465
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 BenefitYes
Long Term Disability Insurance Welfare BenefitYes
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 $32,533
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,465
Insurance broker organization code?3
Insurance broker nameINSURANCE PLANNING GROUP
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract numberTM05928722
Policy instance 1
Insurance contract or identification numberTM05928722
Number of Individuals Covered119
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $3,994
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
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 BenefitYes
Long Term Disability Insurance Welfare BenefitYes
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 $33,289
Commission paid to Insurance BrokerUSD $3,994
Insurance broker organization code?3
Insurance broker nameINSURANCE PLANNING GROUP

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