| Plan Name | FAIRLAWN HAVEN |
| Plan identification number | 502 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
|
| Company Name: | FAIRLAWN HAVEN |
| Employer identification number (EIN): | 340930124 |
| NAIC Classification: | 623000 |
| NAIC Description: | Nursing and Residential Care Facilities |
Additional information about FAIRLAWN HAVEN
| Jurisdiction of Incorporation: | Ohio Secretary of State Business Services Division |
| Incorporation Date: | 1961-06-22 |
| Company Identification Number: | 301604 |
| Legal Registered Office Address: |
407 E LUTZ RD - ARCHBOLD United States of America (USA) 43502 |
More information about FAIRLAWN HAVEN
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 502 | 2023-07-01 | ||||
| 502 | 2023-07-01 | TODD MOORE | |||
| 502 | 2022-07-01 | ||||
| 502 | 2022-07-01 | TODD MOORE | |||
| 502 | 2021-07-01 | ||||
| 502 | 2021-07-01 | TODD MOORE | |||
| 502 | 2020-07-01 | ||||
| 502 | 2020-01-01 |
| 2023: FAIRLAWN HAVEN 2023 form 5500 responses | ||
|---|---|---|
| 2023-07-01 | Type of plan entity | Single employer plan |
| 2023-07-01 | Plan funding arrangement – Insurance | Yes |
| 2023-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2022: FAIRLAWN HAVEN 2022 form 5500 responses | ||
| 2022-07-01 | Type of plan entity | Single employer plan |
| 2022-07-01 | Plan funding arrangement – Insurance | Yes |
| 2022-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2021: FAIRLAWN HAVEN 2021 form 5500 responses | ||
| 2021-07-01 | Type of plan entity | Single employer plan |
| 2021-07-01 | Plan funding arrangement – Insurance | Yes |
| 2021-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2020: FAIRLAWN HAVEN 2020 form 5500 responses | ||
| 2020-07-01 | Type of plan entity | Single employer plan |
| 2020-07-01 | Plan funding arrangement – Insurance | Yes |
| 2020-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2020-01-01 | Type of plan entity | Single employer plan |
| 2020-01-01 | First time form 5500 has been submitted | Yes |
| 2020-01-01 | This return/report is a short plan year return/report (less than 12 months) | Yes |
| 2020-01-01 | Plan funding arrangement – Insurance | Yes |
| 2020-01-01 | Plan benefit arrangement – Insurance | Yes |
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) | |||||||||||||||||
| Policy contract number | 09Q6059 | ||||||||||||||||
| Policy instance | 2 | ||||||||||||||||
| |||||||||||||||||
| AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 ) | |||||||||||||||||
| Policy contract number | G00616703000000 | ||||||||||||||||
| Policy instance | 1 | ||||||||||||||||
| |||||||||||||||||
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) | |||||||||||||||||
| Policy contract number | 09Q6059 | ||||||||||||||||
| Policy instance | 2 | ||||||||||||||||
| AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 ) | |||||||||||||||||
| Policy contract number | G00616703000000 | ||||||||||||||||
| Policy instance | 1 | ||||||||||||||||
| ALL SAVERS INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 82406 ) | |||||||||||||||||
| Policy contract number | 5400 22772 | ||||||||||||||||
| Policy instance | 2 | ||||||||||||||||
| AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 ) | |||||||||||||||||
| Policy contract number | G00616703000000 | ||||||||||||||||
| Policy instance | 1 | ||||||||||||||||
| ALL SAVERS INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 82406 ) | |||||||||||||||||
| Policy contract number | 5400 22772 | ||||||||||||||||
| Policy instance | 2 | ||||||||||||||||
| AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 ) | |||||||||||||||||
| Policy contract number | G00616703000000 | ||||||||||||||||
| Policy instance | 1 | ||||||||||||||||
| AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 ) | |||||||||||||||||
| Policy contract number | G00616703000000 | ||||||||||||||||
| Policy instance | 2 | ||||||||||||||||
| MEDICAL MUTUAL OF OHIO (National Association of Insurance Commissioners NAIC id number: 29076 ) | |||||||||||||||||
| Policy contract number | 0071734-01 | ||||||||||||||||
| Policy instance | 1 | ||||||||||||||||