401k Plan data: TANABELL HEALTH SERVICES EMPLOYEE BENEFIT PLAN plan

TANABELL HEALTH SERVICES EMPLOYEE BENEFIT PLAN 401k Plan overview

Plan Name	TANABELL HEALTH SERVICES EMPLOYEE BENEFIT PLAN
Plan identification number	501

TANABELL HEALTH SERVICES EMPLOYEE BENEFIT PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) Dental Vision Unfunded, fully insured, or combination unfunded/insured welfare plan that will not file a Form 5500 for next plan year pursuant to 29 CFR 2520.104-20.

401k Sponsoring company profile

TANABELL HEALTH SERVICES, INC. has sponsored the creation of one or more 401k plans.

Company Name: TANABELL HEALTH SERVICES, INC.

Employer identification number (EIN): 208277059

NAIC Classification: 621610
NAIC Description: Home Health Care Services

Form 5500 Filing Information

Submission information for form 5500 for 401k plan TANABELL HEALTH SERVICES EMPLOYEE BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2023-04-01 TROY V BELL 2024-10-21

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
501	2023-04-01	TROY V BELL	2024-10-21

Plan Statistics for TANABELL HEALTH SERVICES EMPLOYEE BENEFIT PLAN

401k plan membership statisitcs for TANABELL HEALTH SERVICES EMPLOYEE BENEFIT PLAN

Measure Date Value
2023: TANABELL HEALTH SERVICES EMPLOYEE BENEFIT PLAN 2023 401k membership
Total participants, beginning-of-year 2023-04-01 108
Total number of active participants reported on line 7a of the Form 5500 2023-04-01 80
Number of retired or separated participants receiving benefits 2023-04-01 0
Number of other retired or separated participants entitled to future benefits 2023-04-01 0
Total of all active and inactive participants 2023-04-01 80
Number of employers contributing to the scheme 2023-04-01 0

Measure	Date	Value
2023: TANABELL HEALTH SERVICES EMPLOYEE BENEFIT PLAN 2023 401k membership
Total participants, beginning-of-year	2023-04-01	108
Total number of active participants reported on line 7a of the Form 5500	2023-04-01	80
Number of retired or separated participants receiving benefits	2023-04-01	0
Number of other retired or separated participants entitled to future benefits	2023-04-01	0
Total of all active and inactive participants	2023-04-01	80
Number of employers contributing to the scheme	2023-04-01	0

Form 5500 Responses for TANABELL HEALTH SERVICES EMPLOYEE BENEFIT PLAN

2023: TANABELL HEALTH SERVICES EMPLOYEE BENEFIT PLAN 2023 form 5500 responses
2023-04-01	Type of plan entity	Single employer plan
2023-04-01	First time form 5500 has been submitted	Yes
2023-04-01	Plan funding arrangement – Insurance	Yes
2023-04-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

BLUE CROSS OF IDAHO HEALTH SERVICE INC. (National Association of Insurance Commissioners NAIC id number: 60095 )

Policy contract number

10032905

Policy instance

Insurance contract or identification number	10032905
Number of Individuals Covered	127
Insurance policy start date	2023-04-01
Insurance policy end date	2024-03-31
Total amount of commissions paid to insurance broker	USD $32,002
Total amount of fees paid to insurance company	USD $0
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $829,853
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )

Policy contract number

10-061686

Policy instance

Insurance contract or identification number	10-061686
Number of Individuals Covered	145
Insurance policy start date	2023-04-01
Insurance policy end date	2024-03-31
Total amount of commissions paid to insurance broker	USD $3,966
Total amount of fees paid to insurance company	USD $0
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $39,657
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

UNITED HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 63983 )

Policy contract number

GV-5087

Policy instance

Insurance contract or identification number	GV-5087
Number of Individuals Covered	79
Insurance policy start date	2023-04-01
Insurance policy end date	2024-03-31
Total amount of commissions paid to insurance broker	USD $914
Total amount of fees paid to insurance company	USD $0
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $9,415
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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Company Name:	TANABELL HEALTH SERVICES, INC.
Employer identification number (EIN):	208277059
NAIC Classification:	621610
NAIC Description:	Home Health Care Services