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| Plan Name | ST CAMILLUS GROUP VISION INSURANCE |
| Plan identification number | 504 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | THE CENTERS AT ST CAMILLUS |
| Employer identification number (EIN): | 161085780 |
| NAIC Classification: | 623000 |
| NAIC Description: | Nursing and Residential Care Facilities |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 504 | 2018-11-01 | CARIN PREDMORE | 2020-08-14 | ||
| 504 | 2017-11-01 | CARIN PREDMORE | 2019-08-14 | ||
| 504 | 2016-11-01 |
| Measure | Date | Value |
|---|---|---|
| 2018: ST CAMILLUS GROUP VISION INSURANCE 2018 401k membership | ||
| Total participants, beginning-of-year | 2018-11-01 | 189 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-11-01 | 191 |
| Number of retired or separated participants receiving benefits | 2018-11-01 | 1 |
| Total of all active and inactive participants | 2018-11-01 | 192 |
| 2017: ST CAMILLUS GROUP VISION INSURANCE 2017 401k membership | ||
| Total participants, beginning-of-year | 2017-11-01 | 201 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-11-01 | 188 |
| Number of retired or separated participants receiving benefits | 2017-11-01 | 1 |
| Total of all active and inactive participants | 2017-11-01 | 189 |
| 2016: ST CAMILLUS GROUP VISION INSURANCE 2016 401k membership | ||
| Total participants, beginning-of-year | 2016-11-01 | 221 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-11-01 | 199 |
| Number of retired or separated participants receiving benefits | 2016-11-01 | 2 |
| Total of all active and inactive participants | 2016-11-01 | 201 |
| 2018: ST CAMILLUS GROUP VISION INSURANCE 2018 form 5500 responses | ||
|---|---|---|
| 2018-11-01 | Type of plan entity | Mulitple employer plan |
| 2018-11-01 | Plan funding arrangement – Insurance | Yes |
| 2018-11-01 | Plan benefit arrangement – Insurance | Yes |
| 2017: ST CAMILLUS GROUP VISION INSURANCE 2017 form 5500 responses | ||
| 2017-11-01 | Type of plan entity | Mulitple employer plan |
| 2017-11-01 | Plan funding arrangement – Insurance | Yes |
| 2017-11-01 | Plan benefit arrangement – Insurance | Yes |
| 2016: ST CAMILLUS GROUP VISION INSURANCE 2016 form 5500 responses | ||
| 2016-11-01 | Type of plan entity | Mulitple employer plan |
| 2016-11-01 | Plan funding arrangement – Insurance | Yes |
| 2016-11-01 | Plan benefit arrangement – Insurance | Yes |
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) | |||||||||||||||||||||||
| Policy contract number | 00505329 | ||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||
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| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) | |||||||||||||||||||||||
| Policy contract number | 00505329 | ||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||
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