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AGELESS LIVING HOME HEALTH BENEFIT AND WELFARE PLAN 401k Plan overview

Plan NameAGELESS LIVING HOME HEALTH BENEFIT AND WELFARE PLAN
Plan identification number 501

AGELESS LIVING HOME HEALTH BENEFIT AND WELFARE PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Vision
  • Death benefits (include travel accident but not life insurance)

401k Sponsoring company profile

AGELESS LIVING HOME HEALTH, LLC has sponsored the creation of one or more 401k plans.

Company Name:AGELESS LIVING HOME HEALTH, LLC
Employer identification number (EIN):273020920
NAIC Classification:623000
NAIC Description: Nursing and Residential Care Facilities

Additional information about AGELESS LIVING HOME HEALTH, LLC

Jurisdiction of Incorporation: Texas Secretary of State
Incorporation Date: 2010-07-08
Company Identification Number: 0801290895
Legal Registered Office Address: PO BOX 1267

PROSPER
United States of America (USA)
75078

More information about AGELESS LIVING HOME HEALTH, LLC

Form 5500 Filing Information

Submission information for form 5500 for 401k plan AGELESS LIVING HOME HEALTH BENEFIT AND WELFARE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012022-07-01MICHAEL ALLEY2023-12-08
5012021-07-01MICHAEL ALLEY2022-11-29
5012020-07-01MICHAEL ALLEY2021-10-29
5012019-07-01MICHAEL ALLEY2021-01-21
5012018-07-01MICHAEL ALLEY2019-10-23
5012017-07-01MICHAEL ALLEY2019-04-11

Plan Statistics for AGELESS LIVING HOME HEALTH BENEFIT AND WELFARE PLAN

401k plan membership statisitcs for AGELESS LIVING HOME HEALTH BENEFIT AND WELFARE PLAN

Measure Date Value
2022: AGELESS LIVING HOME HEALTH BENEFIT AND WELFARE PLAN 2022 401k membership
Total participants, beginning-of-year2022-07-01216
Total number of active participants reported on line 7a of the Form 55002022-07-01350
Number of retired or separated participants receiving benefits2022-07-010
Number of other retired or separated participants entitled to future benefits2022-07-010
Total of all active and inactive participants2022-07-01350
Number of employers contributing to the scheme2022-07-010
2021: AGELESS LIVING HOME HEALTH BENEFIT AND WELFARE PLAN 2021 401k membership
Total participants, beginning-of-year2021-07-01216
Total number of active participants reported on line 7a of the Form 55002021-07-01216
Number of retired or separated participants receiving benefits2021-07-010
Number of other retired or separated participants entitled to future benefits2021-07-010
Total of all active and inactive participants2021-07-01216
Number of employers contributing to the scheme2021-07-010
2020: AGELESS LIVING HOME HEALTH BENEFIT AND WELFARE PLAN 2020 401k membership
Total participants, beginning-of-year2020-07-01219
Total number of active participants reported on line 7a of the Form 55002020-07-01239
Number of retired or separated participants receiving benefits2020-07-010
Number of other retired or separated participants entitled to future benefits2020-07-010
Total of all active and inactive participants2020-07-01239
Number of employers contributing to the scheme2020-07-010
2019: AGELESS LIVING HOME HEALTH BENEFIT AND WELFARE PLAN 2019 401k membership
Total participants, beginning-of-year2019-07-01272
Total number of active participants reported on line 7a of the Form 55002019-07-01219
Number of retired or separated participants receiving benefits2019-07-010
Number of other retired or separated participants entitled to future benefits2019-07-010
Total of all active and inactive participants2019-07-01219
Number of employers contributing to the scheme2019-07-010
2018: AGELESS LIVING HOME HEALTH BENEFIT AND WELFARE PLAN 2018 401k membership
Total participants, beginning-of-year2018-07-01113
Total number of active participants reported on line 7a of the Form 55002018-07-01272
Number of retired or separated participants receiving benefits2018-07-010
Number of other retired or separated participants entitled to future benefits2018-07-010
Total of all active and inactive participants2018-07-01272
Number of employers contributing to the scheme2018-07-010
2017: AGELESS LIVING HOME HEALTH BENEFIT AND WELFARE PLAN 2017 401k membership
Total participants, beginning-of-year2017-07-01100
Total number of active participants reported on line 7a of the Form 55002017-07-01113
Number of retired or separated participants receiving benefits2017-07-010
Number of other retired or separated participants entitled to future benefits2017-07-010
Total of all active and inactive participants2017-07-01113
Number of employers contributing to the scheme2017-07-010

Form 5500 Responses for AGELESS LIVING HOME HEALTH BENEFIT AND WELFARE PLAN

2022: AGELESS LIVING HOME HEALTH BENEFIT AND WELFARE PLAN 2022 form 5500 responses
2022-07-01Type of plan entitySingle employer plan
2022-07-01Plan funding arrangement – InsuranceYes
2022-07-01Plan funding arrangement – General assets of the sponsorYes
2022-07-01Plan benefit arrangement – InsuranceYes
2022-07-01Plan benefit arrangement – General assets of the sponsorYes
2021: AGELESS LIVING HOME HEALTH BENEFIT AND WELFARE PLAN 2021 form 5500 responses
2021-07-01Type of plan entitySingle employer plan
2021-07-01Plan funding arrangement – InsuranceYes
2021-07-01Plan benefit arrangement – InsuranceYes
2020: AGELESS LIVING HOME HEALTH BENEFIT AND WELFARE PLAN 2020 form 5500 responses
2020-07-01Type of plan entitySingle employer plan
2020-07-01Plan funding arrangement – InsuranceYes
2020-07-01Plan benefit arrangement – InsuranceYes
2019: AGELESS LIVING HOME HEALTH BENEFIT AND WELFARE PLAN 2019 form 5500 responses
2019-07-01Type of plan entitySingle employer plan
2019-07-01Plan funding arrangement – InsuranceYes
2019-07-01Plan benefit arrangement – InsuranceYes
2018: AGELESS LIVING HOME HEALTH BENEFIT AND WELFARE PLAN 2018 form 5500 responses
2018-07-01Type of plan entitySingle employer plan
2018-07-01Plan funding arrangement – InsuranceYes
2018-07-01Plan benefit arrangement – InsuranceYes
2017: AGELESS LIVING HOME HEALTH BENEFIT AND WELFARE PLAN 2017 form 5500 responses
2017-07-01Type of plan entitySingle employer plan
2017-07-01First time form 5500 has been submittedYes
2017-07-01Plan funding arrangement – InsuranceYes
2017-07-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number924770
Policy instance 1
Insurance contract or identification number924770
Number of Individuals Covered350
Insurance policy start date2022-07-01
Insurance policy end date2023-06-30
Total amount of commissions paid to insurance brokerUSD $11,909
Total amount of fees paid to insurance companyUSD $1,072
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $111,708
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $11,909
Amount paid for insurance broker fees1072
Additional information about fees paid to insurance brokerSERVICE FEE AGREEMENT
Insurance broker organization code?3
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number
Policy instance 1
Number of Individuals Covered341
Insurance policy start date2021-07-01
Insurance policy end date2022-06-30
Total amount of commissions paid to insurance brokerUSD $9,672
Total amount of fees paid to insurance companyUSD $52,596
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $1,042,114
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,659
Amount paid for insurance broker fees52596
Additional information about fees paid to insurance brokerSERVICE FEE AGREEMENT
Insurance broker organization code?3
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )
Policy contract number242804
Policy instance 1
Insurance contract or identification number242804
Number of Individuals Covered220
Insurance policy start date2020-07-01
Insurance policy end date2021-06-30
Total amount of commissions paid to insurance brokerUSD $36,778
Total amount of fees paid to insurance companyUSD $1,098
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $989,714
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $36,778
Amount paid for insurance broker fees1098
Additional information about fees paid to insurance brokerSPECIAL PROGRAMS
Insurance broker organization code?3
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract numberF022833
Policy instance 2
Insurance contract or identification numberF022833
Number of Individuals Covered239
Insurance policy start date2020-07-01
Insurance policy end date2021-06-30
Total amount of commissions paid to insurance brokerUSD $2,933
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $26,078
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,933
Amount paid for insurance broker fees0
Insurance broker organization code?3
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )
Policy contract number242804
Policy instance 1
Insurance contract or identification number242804
Number of Individuals Covered229
Insurance policy start date2019-07-01
Insurance policy end date2020-06-30
Total amount of commissions paid to insurance brokerUSD $42,422
Total amount of fees paid to insurance companyUSD $9,735
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $940,459
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $42,422
Amount paid for insurance broker fees9735
Additional information about fees paid to insurance brokerSPECIAL PROGRAMS NON-MONETARY COMPENSATION
Insurance broker organization code?3
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract numberF022833
Policy instance 2
Insurance contract or identification numberF022833
Number of Individuals Covered219
Insurance policy start date2019-07-01
Insurance policy end date2020-06-30
Total amount of commissions paid to insurance brokerUSD $2,684
Total amount of fees paid to insurance companyUSD $1,795
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $23,928
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,684
Amount paid for insurance broker fees1795
Additional information about fees paid to insurance brokerADDITIONAL COMPENSATION
Insurance broker organization code?3
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )
Policy contract number242804
Policy instance 1
Insurance contract or identification number242804
Number of Individuals Covered272
Insurance policy start date2018-07-01
Insurance policy end date2019-06-30
Total amount of commissions paid to insurance brokerUSD $52,661
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,016,644
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $52,661
Amount paid for insurance broker fees0
Insurance broker organization code?3
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract numberF022833
Policy instance 2
Insurance contract or identification numberF022833
Number of Individuals Covered222
Insurance policy start date2018-07-01
Insurance policy end date2019-06-30
Total amount of commissions paid to insurance brokerUSD $5,321
Total amount of fees paid to insurance companyUSD $791
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $41,992
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,321
Amount paid for insurance broker fees791
Additional information about fees paid to insurance brokerADDITIONAL COMPENSATION
Insurance broker organization code?3
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number608117
Policy instance 1
Insurance contract or identification number608117
Number of Individuals Covered266
Insurance policy start date2017-07-01
Insurance policy end date2018-06-30
Total amount of commissions paid to insurance brokerUSD $40,846
Total amount of fees paid to insurance companyUSD $1,174
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $782,512
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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