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| Plan Name | QUIPT HOME MEDICAL HEALTH AND WELFARE BENEFIT PLAN |
| Plan identification number | 503 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | QUIPT HOME MEDICAL |
| Employer identification number (EIN): | 384005391 |
| NAIC Classification: | 621399 |
| NAIC Description: | Offices of All Other Miscellaneous Health Practitioners |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 503 | 2024-01-01 | KIMBERLY MARSHALL | |||
| 503 | 2023-10-01 | KIMBERLY CHILDERS | 2024-07-30 | ||
| 503 | 2022-10-01 | KIMBERLY CHILDERS | 2024-04-09 | ||
| 503 | 2021-10-01 | KIMBERLY CHILDERS | 2023-04-28 | ||
| 503 | 2020-10-01 | KIMBERLY CHILDERS | 2022-04-29 |
| 2023: QUIPT HOME MEDICAL HEALTH AND WELFARE BENEFIT PLAN 2023 form 5500 responses | ||
|---|---|---|
| 2023-10-01 | Type of plan entity | Single employer plan |
| 2023-10-01 | This return/report is a short plan year return/report (less than 12 months) | Yes |
| 2023-10-01 | Plan funding arrangement – Insurance | Yes |
| 2023-10-01 | Plan benefit arrangement – Insurance | Yes |
| 2022: QUIPT HOME MEDICAL HEALTH AND WELFARE BENEFIT PLAN 2022 form 5500 responses | ||
| 2022-10-01 | Type of plan entity | Single employer plan |
| 2022-10-01 | Plan funding arrangement – Insurance | Yes |
| 2022-10-01 | Plan benefit arrangement – Insurance | Yes |
| 2021: QUIPT HOME MEDICAL HEALTH AND WELFARE BENEFIT PLAN 2021 form 5500 responses | ||
| 2021-10-01 | Type of plan entity | Single employer plan |
| 2021-10-01 | Plan funding arrangement – Insurance | Yes |
| 2021-10-01 | Plan benefit arrangement – Insurance | Yes |
| 2020: QUIPT HOME MEDICAL HEALTH AND WELFARE BENEFIT PLAN 2020 form 5500 responses | ||
| 2020-10-01 | Type of plan entity | Single employer plan |
| 2020-10-01 | First time form 5500 has been submitted | Yes |
| 2020-10-01 | Plan funding arrangement – Insurance | Yes |
| 2020-10-01 | Plan benefit arrangement – Insurance | Yes |
| ANTHEM HEALTH PLAN OF KENTUCKY D.B.A. ANTHEM BLUECROSS BLUESHIELD (National Association of Insurance Commissioners NAIC id number: 95120 ) | |||||||||||||||||||||||||
| Policy contract number | L06467 | ||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||
| |||||||||||||||||||||||||
| SYMETRA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68608 ) | |||||||||||||||||||||||||
| Policy contract number | 01 020347 00 | ||||||||||||||||||||||||
| Policy instance | 2 | ||||||||||||||||||||||||
| |||||||||||||||||||||||||
| ANTHEM HEALTH PLAN OF KENTUCKY D.B.A. ANTHEM BLUECROSS BLUESHIELD (National Association of Insurance Commissioners NAIC id number: 95120 ) | |||||||||||||||||||||||||
| Policy contract number | L06467 | ||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||
| SYMETRA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68608 ) | |||||||||||||||||||||||||
| Policy contract number | 01 020347 00 | ||||||||||||||||||||||||
| Policy instance | 2 | ||||||||||||||||||||||||
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) | |||||||||||||||||||||||||
| Policy contract number | 0922284 | ||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||
| SYMETRA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68608 ) | |||||||||||||||||||||||||
| Policy contract number | 01 020347 00 | ||||||||||||||||||||||||
| Policy instance | 2 | ||||||||||||||||||||||||
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) | |||||||||||||||||||||||||
| Policy contract number | 0922284 | ||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||
| AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 ) | |||||||||||||||||||||||||
| Policy contract number | G 00615561 | ||||||||||||||||||||||||
| Policy instance | 2 | ||||||||||||||||||||||||
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