401k Plan data: JEFFERSON REHABILITATION CENTER HEALTH REIMBURSEME plan

JEFFERSON REHABILITATION CENTER HEALTH REIMBURSEME 401k Plan overview

Plan Name	JEFFERSON REHABILITATION CENTER HEALTH REIMBURSEME
Plan identification number	510

JEFFERSON REHABILITATION CENTER HEALTH REIMBURSEME Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) Dental Vision

401k Sponsoring company profile

THE ARC JEFFERSON - ST. LAWRENCE has sponsored the creation of one or more 401k plans.

Company Name: THE ARC JEFFERSON - ST. LAWRENCE

Employer identification number (EIN): 161134631

NAIC Classification: 813000
NAIC Description: Religious, Grantmaking, Civic, Professional, and Similar Organizations

Additional information about THE ARC JEFFERSON - ST. LAWRENCE

Jurisdiction of Incorporation: New York Department of State

Incorporation Date: 1979-10-16

Company Identification Number: 587668

Legal Registered Office Address: GAFFNEY DR
Jefferson
WATERTOWN
United States of America (USA)
13601

More information about THE ARC JEFFERSON - ST. LAWRENCE

Form 5500 Filing Information

Submission information for form 5500 for 401k plan JEFFERSON REHABILITATION CENTER HEALTH REIMBURSEME

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
510 2023-01-01 LYNN PIETROSKI 2024-07-23 LYNN PIETROSKI 2024-07-23
510 2022-01-01
510 2021-01-01
510 2020-01-01
510 2019-01-01
510 2018-01-01
510 2017-01-01 JILL A. ALLEN JILL A. ALLEN 2018-10-02
510 2016-01-01 JILL A. ALLEN JILL A. ALLEN 2017-10-11
510 2015-01-01 JILL A. ALLEN JILL A. ALLEN 2016-10-11
510 2014-01-01 JILL A. ALLEN JILL A. ALLEN 2015-10-07
510 2013-01-01 JILL A. ALLEN JILL A. ALLEN 2014-08-07
510 2012-01-01 JILL A. ALLEN JILL A. ALLEN 2013-10-11
510 2011-01-01 HOWARD W. GANTER HOWARD W. GANTER 2012-10-15
510 2010-01-01 HOWARD W. GANTER HOWARD W. GANTER 2011-10-07

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
510	2023-01-01	LYNN PIETROSKI	2024-07-23	LYNN PIETROSKI	2024-07-23
510	2022-01-01
510	2021-01-01
510	2020-01-01
510	2019-01-01
510	2018-01-01
510	2017-01-01	JILL A. ALLEN		JILL A. ALLEN	2018-10-02
510	2016-01-01	JILL A. ALLEN		JILL A. ALLEN	2017-10-11
510	2015-01-01	JILL A. ALLEN		JILL A. ALLEN	2016-10-11
510	2014-01-01	JILL A. ALLEN		JILL A. ALLEN	2015-10-07
510	2013-01-01	JILL A. ALLEN		JILL A. ALLEN	2014-08-07
510	2012-01-01	JILL A. ALLEN		JILL A. ALLEN	2013-10-11
510	2011-01-01	HOWARD W. GANTER		HOWARD W. GANTER	2012-10-15
510	2010-01-01	HOWARD W. GANTER		HOWARD W. GANTER	2011-10-07

Plan Statistics for JEFFERSON REHABILITATION CENTER HEALTH REIMBURSEME

401k plan membership statisitcs for JEFFERSON REHABILITATION CENTER HEALTH REIMBURSEME

Measure Date Value
2023: JEFFERSON REHABILITATION CENTER HEALTH REIMBURSEME 2023 401k membership
Total participants, beginning-of-year 2023-01-01 472
Total number of active participants reported on line 7a of the Form 5500 2023-01-01 518
Total of all active and inactive participants 2023-01-01 518
2022: JEFFERSON REHABILITATION CENTER HEALTH REIMBURSEME 2022 401k membership
Total participants, beginning-of-year 2022-01-01 391
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 472
Total of all active and inactive participants 2022-01-01 472
2021: JEFFERSON REHABILITATION CENTER HEALTH REIMBURSEME 2021 401k membership
Total participants, beginning-of-year 2021-01-01 439
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 391
Total of all active and inactive participants 2021-01-01 391
2020: JEFFERSON REHABILITATION CENTER HEALTH REIMBURSEME 2020 401k membership
Total participants, beginning-of-year 2020-01-01 471
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 439
Total of all active and inactive participants 2020-01-01 439
2019: JEFFERSON REHABILITATION CENTER HEALTH REIMBURSEME 2019 401k membership
Total participants, beginning-of-year 2019-01-01 471
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 490
Total of all active and inactive participants 2019-01-01 490
2018: JEFFERSON REHABILITATION CENTER HEALTH REIMBURSEME 2018 401k membership
Total participants, beginning-of-year 2018-01-01 423
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 471
Total of all active and inactive participants 2018-01-01 471
2017: JEFFERSON REHABILITATION CENTER HEALTH REIMBURSEME 2017 401k membership
Total participants, beginning-of-year 2017-01-01 418
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 423
Total of all active and inactive participants 2017-01-01 423
2016: JEFFERSON REHABILITATION CENTER HEALTH REIMBURSEME 2016 401k membership
Total participants, beginning-of-year 2016-01-01 554
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 418
Total of all active and inactive participants 2016-01-01 418
2015: JEFFERSON REHABILITATION CENTER HEALTH REIMBURSEME 2015 401k membership
Total participants, beginning-of-year 2015-01-01 587
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 554
Total of all active and inactive participants 2015-01-01 554
2014: JEFFERSON REHABILITATION CENTER HEALTH REIMBURSEME 2014 401k membership
Total participants, beginning-of-year 2014-01-01 413
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 587
Total of all active and inactive participants 2014-01-01 587
2013: JEFFERSON REHABILITATION CENTER HEALTH REIMBURSEME 2013 401k membership
Total participants, beginning-of-year 2013-01-01 428
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 413
Total of all active and inactive participants 2013-01-01 413
2012: JEFFERSON REHABILITATION CENTER HEALTH REIMBURSEME 2012 401k membership
Total participants, beginning-of-year 2012-01-01 503
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 432
Total of all active and inactive participants 2012-01-01 432
2011: JEFFERSON REHABILITATION CENTER HEALTH REIMBURSEME 2011 401k membership
Total participants, beginning-of-year 2011-01-01 434
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 355
Total of all active and inactive participants 2011-01-01 355
2010: JEFFERSON REHABILITATION CENTER HEALTH REIMBURSEME 2010 401k membership
Total participants, beginning-of-year 2010-01-01 497
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 518
Total of all active and inactive participants 2010-01-01 518

Measure	Date	Value
2023: JEFFERSON REHABILITATION CENTER HEALTH REIMBURSEME 2023 401k membership
Total participants, beginning-of-year	2023-01-01	472
Total number of active participants reported on line 7a of the Form 5500	2023-01-01	518
Total of all active and inactive participants	2023-01-01	518
2022: JEFFERSON REHABILITATION CENTER HEALTH REIMBURSEME 2022 401k membership
Total participants, beginning-of-year	2022-01-01	391
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	472
Total of all active and inactive participants	2022-01-01	472
2021: JEFFERSON REHABILITATION CENTER HEALTH REIMBURSEME 2021 401k membership
Total participants, beginning-of-year	2021-01-01	439
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	391
Total of all active and inactive participants	2021-01-01	391
2020: JEFFERSON REHABILITATION CENTER HEALTH REIMBURSEME 2020 401k membership
Total participants, beginning-of-year	2020-01-01	471
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	439
Total of all active and inactive participants	2020-01-01	439
2019: JEFFERSON REHABILITATION CENTER HEALTH REIMBURSEME 2019 401k membership
Total participants, beginning-of-year	2019-01-01	471
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	490
Total of all active and inactive participants	2019-01-01	490
2018: JEFFERSON REHABILITATION CENTER HEALTH REIMBURSEME 2018 401k membership
Total participants, beginning-of-year	2018-01-01	423
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	471
Total of all active and inactive participants	2018-01-01	471
2017: JEFFERSON REHABILITATION CENTER HEALTH REIMBURSEME 2017 401k membership
Total participants, beginning-of-year	2017-01-01	418
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	423
Total of all active and inactive participants	2017-01-01	423
2016: JEFFERSON REHABILITATION CENTER HEALTH REIMBURSEME 2016 401k membership
Total participants, beginning-of-year	2016-01-01	554
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	418
Total of all active and inactive participants	2016-01-01	418
2015: JEFFERSON REHABILITATION CENTER HEALTH REIMBURSEME 2015 401k membership
Total participants, beginning-of-year	2015-01-01	587
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	554
Total of all active and inactive participants	2015-01-01	554
2014: JEFFERSON REHABILITATION CENTER HEALTH REIMBURSEME 2014 401k membership
Total participants, beginning-of-year	2014-01-01	413
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	587
Total of all active and inactive participants	2014-01-01	587
2013: JEFFERSON REHABILITATION CENTER HEALTH REIMBURSEME 2013 401k membership
Total participants, beginning-of-year	2013-01-01	428
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	413
Total of all active and inactive participants	2013-01-01	413
2012: JEFFERSON REHABILITATION CENTER HEALTH REIMBURSEME 2012 401k membership
Total participants, beginning-of-year	2012-01-01	503
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	432
Total of all active and inactive participants	2012-01-01	432
2011: JEFFERSON REHABILITATION CENTER HEALTH REIMBURSEME 2011 401k membership
Total participants, beginning-of-year	2011-01-01	434
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	355
Total of all active and inactive participants	2011-01-01	355
2010: JEFFERSON REHABILITATION CENTER HEALTH REIMBURSEME 2010 401k membership
Total participants, beginning-of-year	2010-01-01	497
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	518
Total of all active and inactive participants	2010-01-01	518

Form 5500 Responses for JEFFERSON REHABILITATION CENTER HEALTH REIMBURSEME

2023: JEFFERSON REHABILITATION CENTER HEALTH REIMBURSEME 2023 form 5500 responses
2023-01-01	Type of plan entity	Single employer plan
2023-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2023-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2022: JEFFERSON REHABILITATION CENTER HEALTH REIMBURSEME 2022 form 5500 responses
2022-01-01	Type of plan entity	Single employer plan
2022-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2022-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2021: JEFFERSON REHABILITATION CENTER HEALTH REIMBURSEME 2021 form 5500 responses
2021-01-01	Type of plan entity	Single employer plan
2021-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2021-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2020: JEFFERSON REHABILITATION CENTER HEALTH REIMBURSEME 2020 form 5500 responses
2020-01-01	Type of plan entity	Single employer plan
2020-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2020-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2019: JEFFERSON REHABILITATION CENTER HEALTH REIMBURSEME 2019 form 5500 responses
2019-01-01	Type of plan entity	Single employer plan
2019-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2019-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2018: JEFFERSON REHABILITATION CENTER HEALTH REIMBURSEME 2018 form 5500 responses
2018-01-01	Type of plan entity	Single employer plan
2018-01-01	Plan funding arrangement – Insurance	Yes
2018-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2018-01-01	Plan benefit arrangement – Insurance	Yes
2018-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2017: JEFFERSON REHABILITATION CENTER HEALTH REIMBURSEME 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2017-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2016: JEFFERSON REHABILITATION CENTER HEALTH REIMBURSEME 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Submission has been amended	Yes
2016-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2016-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2015: JEFFERSON REHABILITATION CENTER HEALTH REIMBURSEME 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2015-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2014: JEFFERSON REHABILITATION CENTER HEALTH REIMBURSEME 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2014-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2013: JEFFERSON REHABILITATION CENTER HEALTH REIMBURSEME 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2013-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2012: JEFFERSON REHABILITATION CENTER HEALTH REIMBURSEME 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2012-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2011: JEFFERSON REHABILITATION CENTER HEALTH REIMBURSEME 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2011-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2010: JEFFERSON REHABILITATION CENTER HEALTH REIMBURSEME 2010 form 5500 responses
2010-01-01	Type of plan entity	Single employer plan
2010-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2010-01-01	Plan benefit arrangement – General assets of the sponsor	Yes

Insurance Providers Used on plan

MVP HEALTH CARE (National Association of Insurance Commissioners NAIC id number: 95521 )

Policy contract number

HRA

Policy instance

Insurance contract or identification number	HRA
Number of Individuals Covered	471
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $25,995
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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Company Name:	THE ARC JEFFERSON - ST. LAWRENCE
Employer identification number (EIN):	161134631
NAIC Classification:	813000
NAIC Description:	Religious, Grantmaking, Civic, Professional, and Similar Organizations

Jurisdiction of Incorporation:	New York Department of State
Incorporation Date:	1979-10-16
Company Identification Number:	587668
Legal Registered Office Address:	GAFFNEY DR Jefferson WATERTOWN United States of America (USA) 13601