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ON MY OWN INDEPENDENT LIVING SERVICES LIFE/AD&D PLAN 401k Plan overview

Plan NameON MY OWN INDEPENDENT LIVING SERVICES LIFE/AD&D PLAN
Plan identification number 501

ON MY OWN INDEPENDENT LIVING SERVICES LIFE/AD&D PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Life insurance
  • Death benefits (include travel accident but not life insurance)

401k Sponsoring company profile

ON MY OWN INDEPENDENT LIVING SERVICES has sponsored the creation of one or more 401k plans.

Company Name:ON MY OWN INDEPENDENT LIVING SERVICES
Employer identification number (EIN):043634250
NAIC Classification:624100
NAIC Description: Individual and Family Services

Additional information about ON MY OWN INDEPENDENT LIVING SERVICES

Jurisdiction of Incorporation: California Department of State
Incorporation Date:
Company Identification Number: C2407772

More information about ON MY OWN INDEPENDENT LIVING SERVICES

Form 5500 Filing Information

Submission information for form 5500 for 401k plan ON MY OWN INDEPENDENT LIVING SERVICES LIFE/AD&D PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012022-12-01MICHELLE RAMIREZ2024-02-09
5012021-12-01MICHELLE RAMIREZ2023-06-07
5012020-12-01JOHN E BUTLER2022-02-25
5012019-12-01JOHN E. BUTLER2021-04-19
5012018-12-01JOHN E. BUTLER2020-02-28
5012017-12-01
5012016-12-01

Plan Statistics for ON MY OWN INDEPENDENT LIVING SERVICES LIFE/AD&D PLAN

401k plan membership statisitcs for ON MY OWN INDEPENDENT LIVING SERVICES LIFE/AD&D PLAN

Measure Date Value
2022: ON MY OWN INDEPENDENT LIVING SERVICES LIFE/AD&D PLAN 2022 401k membership
Total participants, beginning-of-year2022-12-01130
Total number of active participants reported on line 7a of the Form 55002022-12-01130
Number of retired or separated participants receiving benefits2022-12-010
Number of other retired or separated participants entitled to future benefits2022-12-010
Total of all active and inactive participants2022-12-01130
Number of employers contributing to the scheme2022-12-010
2021: ON MY OWN INDEPENDENT LIVING SERVICES LIFE/AD&D PLAN 2021 401k membership
Total participants, beginning-of-year2021-12-01136
Total number of active participants reported on line 7a of the Form 55002021-12-01130
Number of retired or separated participants receiving benefits2021-12-010
Number of other retired or separated participants entitled to future benefits2021-12-010
Total of all active and inactive participants2021-12-01130
Number of employers contributing to the scheme2021-12-010
2020: ON MY OWN INDEPENDENT LIVING SERVICES LIFE/AD&D PLAN 2020 401k membership
Total participants, beginning-of-year2020-12-01117
Total number of active participants reported on line 7a of the Form 55002020-12-01136
Number of retired or separated participants receiving benefits2020-12-010
Number of other retired or separated participants entitled to future benefits2020-12-010
Total of all active and inactive participants2020-12-01136
Number of employers contributing to the scheme2020-12-010
2019: ON MY OWN INDEPENDENT LIVING SERVICES LIFE/AD&D PLAN 2019 401k membership
Total participants, beginning-of-year2019-12-01112
Total number of active participants reported on line 7a of the Form 55002019-12-01185
Number of retired or separated participants receiving benefits2019-12-010
Number of other retired or separated participants entitled to future benefits2019-12-010
Total of all active and inactive participants2019-12-01185
Number of employers contributing to the scheme2019-12-010
2018: ON MY OWN INDEPENDENT LIVING SERVICES LIFE/AD&D PLAN 2018 401k membership
Total participants, beginning-of-year2018-12-01122
Total number of active participants reported on line 7a of the Form 55002018-12-01112
Number of retired or separated participants receiving benefits2018-12-010
Number of other retired or separated participants entitled to future benefits2018-12-010
Total of all active and inactive participants2018-12-01112
Number of employers contributing to the scheme2018-12-010
2017: ON MY OWN INDEPENDENT LIVING SERVICES LIFE/AD&D PLAN 2017 401k membership
Total participants, beginning-of-year2017-12-01121
Total number of active participants reported on line 7a of the Form 55002017-12-01122
Number of retired or separated participants receiving benefits2017-12-010
Number of other retired or separated participants entitled to future benefits2017-12-010
Total of all active and inactive participants2017-12-01122
Number of employers contributing to the scheme2017-12-010
2016: ON MY OWN INDEPENDENT LIVING SERVICES LIFE/AD&D PLAN 2016 401k membership
Total participants, beginning-of-year2016-12-01197
Total number of active participants reported on line 7a of the Form 55002016-12-01121
Number of retired or separated participants receiving benefits2016-12-010
Number of other retired or separated participants entitled to future benefits2016-12-010
Total of all active and inactive participants2016-12-01121

Form 5500 Responses for ON MY OWN INDEPENDENT LIVING SERVICES LIFE/AD&D PLAN

2022: ON MY OWN INDEPENDENT LIVING SERVICES LIFE/AD&D PLAN 2022 form 5500 responses
2022-12-01Type of plan entitySingle employer plan
2022-12-01Plan funding arrangement – InsuranceYes
2022-12-01Plan benefit arrangement – InsuranceYes
2021: ON MY OWN INDEPENDENT LIVING SERVICES LIFE/AD&D PLAN 2021 form 5500 responses
2021-12-01Type of plan entitySingle employer plan
2021-12-01Plan funding arrangement – InsuranceYes
2021-12-01Plan benefit arrangement – InsuranceYes
2020: ON MY OWN INDEPENDENT LIVING SERVICES LIFE/AD&D PLAN 2020 form 5500 responses
2020-12-01Type of plan entitySingle employer plan
2020-12-01Plan funding arrangement – InsuranceYes
2020-12-01Plan benefit arrangement – InsuranceYes
2019: ON MY OWN INDEPENDENT LIVING SERVICES LIFE/AD&D PLAN 2019 form 5500 responses
2019-12-01Type of plan entitySingle employer plan
2019-12-01Plan funding arrangement – InsuranceYes
2019-12-01Plan benefit arrangement – InsuranceYes
2018: ON MY OWN INDEPENDENT LIVING SERVICES LIFE/AD&D PLAN 2018 form 5500 responses
2018-12-01Type of plan entitySingle employer plan
2018-12-01Plan funding arrangement – InsuranceYes
2018-12-01Plan benefit arrangement – InsuranceYes
2017: ON MY OWN INDEPENDENT LIVING SERVICES LIFE/AD&D PLAN 2017 form 5500 responses
2017-12-01Type of plan entitySingle employer plan
2017-12-01Plan funding arrangement – InsuranceYes
2017-12-01Plan benefit arrangement – InsuranceYes
2016: ON MY OWN INDEPENDENT LIVING SERVICES LIFE/AD&D PLAN 2016 form 5500 responses
2016-12-01Type of plan entitySingle employer plan
2016-12-01First time form 5500 has been submittedYes
2016-12-01Plan funding arrangement – InsuranceYes
2016-12-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number10221834
Policy instance 1
Insurance contract or identification number10221834
Number of Individuals Covered129
Insurance policy start date2022-12-01
Insurance policy end date2023-11-30
Total amount of commissions paid to insurance brokerUSD $504
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $3,704
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $504
Amount paid for insurance broker fees0
Insurance broker organization code?3
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number10221834
Policy instance 1
Insurance contract or identification number10221834
Number of Individuals Covered130
Insurance policy start date2021-12-01
Insurance policy end date2022-11-30
Total amount of commissions paid to insurance brokerUSD $468
Total amount of fees paid to insurance companyUSD $37
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $3,469
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $468
Amount paid for insurance broker fees0
Insurance broker organization code?3
Additional information about fees paid to insurance brokerBROKER BONUS
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number10221834
Policy instance 1
Insurance contract or identification number10221834
Number of Individuals Covered151
Insurance policy start date2020-12-01
Insurance policy end date2021-11-30
Total amount of commissions paid to insurance brokerUSD $500
Total amount of fees paid to insurance companyUSD $70
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $3,733
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $500
Amount paid for insurance broker fees0
Insurance broker organization code?3
Additional information about fees paid to insurance brokerBROKER BONUS
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number10221834
Policy instance 1
Insurance contract or identification number10221834
Number of Individuals Covered185
Insurance policy start date2019-12-01
Insurance policy end date2020-11-30
Total amount of commissions paid to insurance brokerUSD $619
Total amount of fees paid to insurance companyUSD $137
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $4,542
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $619
Amount paid for insurance broker fees137
Additional information about fees paid to insurance brokerBROKER BONUS
Insurance broker organization code?3
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number10221834
Policy instance 1
Insurance contract or identification number10221834
Number of Individuals Covered112
Insurance policy start date2018-12-01
Insurance policy end date2019-11-30
Total amount of commissions paid to insurance brokerUSD $387
Total amount of fees paid to insurance companyUSD $105
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $2,733
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $387
Amount paid for insurance broker fees0
Insurance broker organization code?3
Additional information about fees paid to insurance brokerBROKER BONUS
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number10221834
Policy instance 1
Insurance contract or identification number10221834
Number of Individuals Covered122
Insurance policy start date2017-12-01
Insurance policy end date2018-11-30
Total amount of commissions paid to insurance brokerUSD $352
Total amount of fees paid to insurance companyUSD $93
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $2,362
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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