401k Plan data: ANODYNE MEDICAL SERVICES GROUP LIFE AND DENTAL PLAN plan

ANODYNE MEDICAL SERVICES GROUP LIFE AND DENTAL PLAN 401k Plan overview

Plan Name	ANODYNE MEDICAL SERVICES GROUP LIFE AND DENTAL PLAN
Plan identification number	505

ANODYNE MEDICAL SERVICES GROUP LIFE AND DENTAL PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Life insurance Dental Death benefits (include travel accident but not life insurance)

401k Sponsoring company profile

ANODYNE MEDICAL SERVICES CORP has sponsored the creation of one or more 401k plans.

Company Name: ANODYNE MEDICAL SERVICES CORP

Employer identification number (EIN): 042497415

NAIC Classification: 621610
NAIC Description: Home Health Care Services

Form 5500 Filing Information

Submission information for form 5500 for 401k plan ANODYNE MEDICAL SERVICES GROUP LIFE AND DENTAL PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
505 2020-12-01

Plan Statistics for ANODYNE MEDICAL SERVICES GROUP LIFE AND DENTAL PLAN

401k plan membership statisitcs for ANODYNE MEDICAL SERVICES GROUP LIFE AND DENTAL PLAN

Measure Date Value
2020: ANODYNE MEDICAL SERVICES GROUP LIFE AND DENTAL PLAN 2020 401k membership
Total participants, beginning-of-year 2020-12-01 387
Total number of active participants reported on line 7a of the Form 5500 2020-12-01 372
Number of retired or separated participants receiving benefits 2020-12-01 0
Number of other retired or separated participants entitled to future benefits 2020-12-01 0
Total of all active and inactive participants 2020-12-01 372

Measure	Date	Value
2020: ANODYNE MEDICAL SERVICES GROUP LIFE AND DENTAL PLAN 2020 401k membership
Total participants, beginning-of-year	2020-12-01	387
Total number of active participants reported on line 7a of the Form 5500	2020-12-01	372
Number of retired or separated participants receiving benefits	2020-12-01	0
Number of other retired or separated participants entitled to future benefits	2020-12-01	0
Total of all active and inactive participants	2020-12-01	372

Form 5500 Responses for ANODYNE MEDICAL SERVICES GROUP LIFE AND DENTAL PLAN

2020: ANODYNE MEDICAL SERVICES GROUP LIFE AND DENTAL PLAN 2020 form 5500 responses
2020-12-01	Type of plan entity	Single employer plan
2020-12-01	First time form 5500 has been submitted	Yes
2020-12-01	Submission has been amended	No
2020-12-01	This submission is the final filing	No
2020-12-01	This return/report is a short plan year return/report (less than 12 months)	No
2020-12-01	Plan is a collectively bargained plan	No
2020-12-01	Plan funding arrangement – Insurance	Yes
2020-12-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )

Policy contract number

5973524

Policy instance

Insurance contract or identification number	5973524
Number of Individuals Covered	372
Insurance policy start date	2020-12-01
Insurance policy end date	2021-11-30
Total amount of commissions paid to insurance broker	USD $3,370
Total amount of fees paid to insurance company	USD $787
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	Yes
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Other welfare benefits provided	ACCIDENTAL DEATH & DISMEMBERMENT
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 $73,878
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $3,370
Amount paid for insurance broker fees	787
Additional information about fees paid to insurance broker	SUPPLEMENTAL COMPENSATION
Insurance broker organization code?	3

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Company Name:	ANODYNE MEDICAL SERVICES CORP
Employer identification number (EIN):	042497415
NAIC Classification:	621610
NAIC Description:	Home Health Care Services