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CONCORDIS SENIOR LIVING OF CENTRAL FLORIDA, LLC WELFARE BENEFIT PLAN 401k Plan overview

Plan NameCONCORDIS SENIOR LIVING OF CENTRAL FLORIDA, LLC WELFARE BENEFIT PLAN
Plan identification number 501

CONCORDIS SENIOR LIVING OF CENTRAL FLORIDA, LLC WELFARE BENEFIT PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Vision
  • Temporary disability (accident and sickness)
  • Long-term disability cover
  • Death benefits (include travel accident but not life insurance)

401k Sponsoring company profile

CONCORDIS SENIOR LIVING OF CENTRAL FLORIDA, LLC has sponsored the creation of one or more 401k plans.

Company Name:CONCORDIS SENIOR LIVING OF CENTRAL FLORIDA, LLC
Employer identification number (EIN):320407846
NAIC Classification:623000
NAIC Description: Nursing and Residential Care Facilities

Additional information about CONCORDIS SENIOR LIVING OF CENTRAL FLORIDA, LLC

Jurisdiction of Incorporation: Florida Department of State Division of Corporations
Incorporation Date: 2013-04-22
Company Identification Number: L13000058025
Legal Registered Office Address: 1740 SE 18th Street

Ocala

34471

More information about CONCORDIS SENIOR LIVING OF CENTRAL FLORIDA, LLC

Form 5500 Filing Information

Submission information for form 5500 for 401k plan CONCORDIS SENIOR LIVING OF CENTRAL FLORIDA, LLC WELFARE BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012022-01-01TRAVIS WATKINS2023-07-20
5012021-07-01TRAVIS WATKINS2022-06-09
5012020-07-01TRAVIS WATKINS2021-11-04
5012019-07-01TRAVIS WATKINS2020-11-12

Plan Statistics for CONCORDIS SENIOR LIVING OF CENTRAL FLORIDA, LLC WELFARE BENEFIT PLAN

401k plan membership statisitcs for CONCORDIS SENIOR LIVING OF CENTRAL FLORIDA, LLC WELFARE BENEFIT PLAN

Measure Date Value
2022: CONCORDIS SENIOR LIVING OF CENTRAL FLORIDA, LLC WELFARE BENEFIT PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-01192
Total number of active participants reported on line 7a of the Form 55002022-01-01347
Number of retired or separated participants receiving benefits2022-01-010
Number of other retired or separated participants entitled to future benefits2022-01-010
Total of all active and inactive participants2022-01-01347
Number of employers contributing to the scheme2022-01-010
2021: CONCORDIS SENIOR LIVING OF CENTRAL FLORIDA, LLC WELFARE BENEFIT PLAN 2021 401k membership
Total participants, beginning-of-year2021-07-01188
Total number of active participants reported on line 7a of the Form 55002021-07-01192
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 participants2021-07-01192
Number of employers contributing to the scheme2021-07-010
2020: CONCORDIS SENIOR LIVING OF CENTRAL FLORIDA, LLC WELFARE BENEFIT PLAN 2020 401k membership
Total participants, beginning-of-year2020-07-01178
Total number of active participants reported on line 7a of the Form 55002020-07-01188
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 participants2020-07-01188
Number of employers contributing to the scheme2020-07-010
2019: CONCORDIS SENIOR LIVING OF CENTRAL FLORIDA, LLC WELFARE BENEFIT PLAN 2019 401k membership
Total participants, beginning-of-year2019-07-01171
Total number of active participants reported on line 7a of the Form 55002019-07-01178
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 participants2019-07-01178
Number of employers contributing to the scheme2019-07-010

Form 5500 Responses for CONCORDIS SENIOR LIVING OF CENTRAL FLORIDA, LLC WELFARE BENEFIT PLAN

2022: CONCORDIS SENIOR LIVING OF CENTRAL FLORIDA, LLC WELFARE BENEFIT PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan benefit arrangement – InsuranceYes
2021: CONCORDIS SENIOR LIVING OF CENTRAL FLORIDA, LLC WELFARE BENEFIT PLAN 2021 form 5500 responses
2021-07-01Type of plan entitySingle employer plan
2021-07-01This return/report is a short plan year return/report (less than 12 months)Yes
2021-07-01Plan funding arrangement – InsuranceYes
2021-07-01Plan benefit arrangement – InsuranceYes
2020: CONCORDIS SENIOR LIVING OF CENTRAL FLORIDA, LLC WELFARE BENEFIT 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: CONCORDIS SENIOR LIVING OF CENTRAL FLORIDA, LLC WELFARE BENEFIT PLAN 2019 form 5500 responses
2019-07-01Type of plan entitySingle employer plan
2019-07-01First time form 5500 has been submittedYes
2019-07-01Plan funding arrangement – InsuranceYes
2019-07-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number4W1541
Policy instance 1
Insurance contract or identification number4W1541
Number of Individuals Covered152
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $48,089
Total amount of fees paid to insurance companyUSD $1,100
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $935,050
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $48,089
Amount paid for insurance broker fees583
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number400243345
Policy instance 2
Insurance contract or identification number400243345
Number of Individuals Covered347
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $16,132
Total amount of fees paid to insurance companyUSD $14,713
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $124,665
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $16,132
Amount paid for insurance broker fees0
Insurance broker organization code?3
Additional information about fees paid to insurance brokerOVERRIDES, BROKER BONUS
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number4W1541
Policy instance 1
Insurance contract or identification number4W1541
Number of Individuals Covered115
Insurance policy start date2021-07-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $16,899
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $377,331
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $16,899
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 number400243345
Policy instance 2
Insurance contract or identification number400243345
Number of Individuals Covered192
Insurance policy start date2021-07-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $7,353
Total amount of fees paid to insurance companyUSD $5,990
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $57,502
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,353
Amount paid for insurance broker fees0
Insurance broker organization code?3
Additional information about fees paid to insurance brokerOVERRIDES, BROKER BONUS
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number4W1541
Policy instance 1
Insurance contract or identification number4W1541
Number of Individuals Covered103
Insurance policy start date2020-07-01
Insurance policy end date2021-06-30
Total amount of commissions paid to insurance brokerUSD $30,019
Total amount of fees paid to insurance companyUSD $297
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $597,683
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $30,019
Amount paid for insurance broker fees297
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number400243345
Policy instance 2
Insurance contract or identification number400243345
Number of Individuals Covered188
Insurance policy start date2020-07-01
Insurance policy end date2021-06-30
Total amount of commissions paid to insurance brokerUSD $12,274
Total amount of fees paid to insurance companyUSD $11,497
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $96,059
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $12,274
Amount paid for insurance broker fees0
Insurance broker organization code?3
Additional information about fees paid to insurance brokerOVERRIDES BROKER BONUS
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number4W1541
Policy instance 1
Insurance contract or identification number4W1541
Number of Individuals Covered100
Insurance policy start date2019-07-01
Insurance policy end date2020-06-30
Total amount of commissions paid to insurance brokerUSD $25,136
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $504,005
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $25,136
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 number400243345
Policy instance 2
Insurance contract or identification number400243345
Number of Individuals Covered178
Insurance policy start date2019-07-01
Insurance policy end date2020-06-30
Total amount of commissions paid to insurance brokerUSD $9,012
Total amount of fees paid to insurance companyUSD $10,519
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $72,212
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9,012
Amount paid for insurance broker fees0
Insurance broker organization code?3
Additional information about fees paid to insurance brokerOVERRIDES BROKER BONUS

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