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HEALTH BENEFIT PLAN FOR NEWAYGO MEDICAL CARE FACILITY 401k Plan overview

Plan NameHEALTH BENEFIT PLAN FOR NEWAYGO MEDICAL CARE FACILITY
Plan identification number 501

HEALTH BENEFIT PLAN FOR NEWAYGO MEDICAL CARE FACILITY Benefits

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

401k Sponsoring company profile

NEWAYGO MEDICAL CARE FACILITY has sponsored the creation of one or more 401k plans.

Company Name:NEWAYGO MEDICAL CARE FACILITY
Employer identification number (EIN):383040613
NAIC Classification:623000
NAIC Description: Nursing and Residential Care Facilities

Form 5500 Filing Information

Submission information for form 5500 for 401k plan HEALTH BENEFIT PLAN FOR NEWAYGO MEDICAL CARE FACILITY

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012017-03-01
5012017-03-01

Plan Statistics for HEALTH BENEFIT PLAN FOR NEWAYGO MEDICAL CARE FACILITY

401k plan membership statisitcs for HEALTH BENEFIT PLAN FOR NEWAYGO MEDICAL CARE FACILITY

Measure Date Value
2017: HEALTH BENEFIT PLAN FOR NEWAYGO MEDICAL CARE FACILITY 2017 401k membership
Total participants, beginning-of-year2017-03-01110
Total number of active participants reported on line 7a of the Form 55002017-03-01107
Number of retired or separated participants receiving benefits2017-03-010
Number of other retired or separated participants entitled to future benefits2017-03-010
Total of all active and inactive participants2017-03-01107
Number of employers contributing to the scheme2017-03-010

Form 5500 Responses for HEALTH BENEFIT PLAN FOR NEWAYGO MEDICAL CARE FACILITY

2017: HEALTH BENEFIT PLAN FOR NEWAYGO MEDICAL CARE FACILITY 2017 form 5500 responses
2017-03-01Type of plan entitySingle employer plan
2017-03-01First time form 5500 has been submittedYes
2017-03-01Submission has been amendedYes
2017-03-01This submission is the final filingYes
2017-03-01Plan funding arrangement – InsuranceYes
2017-03-01Plan funding arrangement – General assets of the sponsorYes
2017-03-01Plan benefit arrangement – InsuranceYes
2017-03-01Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGLUG0AS5K
Policy instance 1
Insurance contract or identification numberGLUG0AS5K
Number of Individuals Covered114
Insurance policy start date2017-03-01
Insurance policy end date2018-02-28
Total amount of commissions paid to insurance brokerUSD $130
Total amount of fees paid to insurance companyUSD $37
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $1,296
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $130
Amount paid for insurance broker fees37
Additional information about fees paid to insurance brokerOTHER COMPENSATION
Insurance broker organization code?3
Insurance broker nameLIGHTHOUSE GROUP INSURANCE

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