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THE LUTHERAN HOME ASSOCIATION VISION BENEFITS PLAN 401k Plan overview

Plan NameTHE LUTHERAN HOME ASSOCIATION VISION BENEFITS PLAN
Plan identification number 504

THE LUTHERAN HOME ASSOCIATION VISION BENEFITS PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Vision
  • Unfunded, fully insured, or combination unfunded/insured welfare plan that will not file a Form 5500 for next plan year pursuant to 29 CFR 2520.104-20.
  • Unfunded, fully insured, or combination unfunded/insured welfare plan that stopped filing form 5500s in an earlier plan year pursuant to 29 CFR 2520.104-20.

401k Sponsoring company profile

THE LUTHERAN HOME has sponsored the creation of one or more 401k plans.

Company Name:THE LUTHERAN HOME
Employer identification number (EIN):410706147
NAIC Classification:623000
NAIC Description: Nursing and Residential Care Facilities

Form 5500 Filing Information

Submission information for form 5500 for 401k plan THE LUTHERAN HOME ASSOCIATION VISION BENEFITS PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5042021-09-01JODI FOSTER2023-02-27
5042020-09-01BETH WADSLEY2022-01-22
5042019-09-01BETH WADSLEY2021-02-23
5042018-09-01BETH WADSLEY2020-01-17
5042017-09-01
5042016-09-01
5042015-09-01BETH WADSLEY BETH WADSLEY2017-06-12

Plan Statistics for THE LUTHERAN HOME ASSOCIATION VISION BENEFITS PLAN

401k plan membership statisitcs for THE LUTHERAN HOME ASSOCIATION VISION BENEFITS PLAN

Measure Date Value
2021: THE LUTHERAN HOME ASSOCIATION VISION BENEFITS PLAN 2021 401k membership
Total participants, beginning-of-year2021-09-01104
Total number of active participants reported on line 7a of the Form 55002021-09-01132
Number of retired or separated participants receiving benefits2021-09-011
Number of other retired or separated participants entitled to future benefits2021-09-010
Total of all active and inactive participants2021-09-01133
Number of employers contributing to the scheme2021-09-010
2020: THE LUTHERAN HOME ASSOCIATION VISION BENEFITS PLAN 2020 401k membership
Total participants, beginning-of-year2020-09-01110
Total number of active participants reported on line 7a of the Form 55002020-09-01104
Number of retired or separated participants receiving benefits2020-09-013
Number of other retired or separated participants entitled to future benefits2020-09-010
Total of all active and inactive participants2020-09-01107
Number of employers contributing to the scheme2020-09-010
2019: THE LUTHERAN HOME ASSOCIATION VISION BENEFITS PLAN 2019 401k membership
Total participants, beginning-of-year2019-09-01197
Total number of active participants reported on line 7a of the Form 55002019-09-0185
Number of retired or separated participants receiving benefits2019-09-010
Number of other retired or separated participants entitled to future benefits2019-09-010
Total of all active and inactive participants2019-09-0185
Number of employers contributing to the scheme2019-09-010
2018: THE LUTHERAN HOME ASSOCIATION VISION BENEFITS PLAN 2018 401k membership
Total participants, beginning-of-year2018-09-01173
Total number of active participants reported on line 7a of the Form 55002018-09-01197
Number of retired or separated participants receiving benefits2018-09-010
Number of other retired or separated participants entitled to future benefits2018-09-010
Total of all active and inactive participants2018-09-01197
Number of employers contributing to the scheme2018-09-010
2017: THE LUTHERAN HOME ASSOCIATION VISION BENEFITS PLAN 2017 401k membership
Total participants, beginning-of-year2017-09-01163
Total number of active participants reported on line 7a of the Form 55002017-09-01173
Number of retired or separated participants receiving benefits2017-09-010
Number of other retired or separated participants entitled to future benefits2017-09-010
Total of all active and inactive participants2017-09-01173
Number of employers contributing to the scheme2017-09-010
2016: THE LUTHERAN HOME ASSOCIATION VISION BENEFITS PLAN 2016 401k membership
Total participants, beginning-of-year2016-09-01160
Total number of active participants reported on line 7a of the Form 55002016-09-01160
Number of retired or separated participants receiving benefits2016-09-013
Number of other retired or separated participants entitled to future benefits2016-09-010
Total of all active and inactive participants2016-09-01163
2015: THE LUTHERAN HOME ASSOCIATION VISION BENEFITS PLAN 2015 401k membership
Total participants, beginning-of-year2015-09-01177
Total number of active participants reported on line 7a of the Form 55002015-09-01185
Number of retired or separated participants receiving benefits2015-09-010
Number of other retired or separated participants entitled to future benefits2015-09-010
Total of all active and inactive participants2015-09-01185
Total participants2015-09-01185

Form 5500 Responses for THE LUTHERAN HOME ASSOCIATION VISION BENEFITS PLAN

2021: THE LUTHERAN HOME ASSOCIATION VISION BENEFITS PLAN 2021 form 5500 responses
2021-09-01Type of plan entitySingle employer plan
2021-09-01Plan funding arrangement – InsuranceYes
2021-09-01Plan benefit arrangement – InsuranceYes
2020: THE LUTHERAN HOME ASSOCIATION VISION BENEFITS PLAN 2020 form 5500 responses
2020-09-01Type of plan entitySingle employer plan
2020-09-01Plan funding arrangement – InsuranceYes
2020-09-01Plan benefit arrangement – InsuranceYes
2019: THE LUTHERAN HOME ASSOCIATION VISION BENEFITS PLAN 2019 form 5500 responses
2019-09-01Type of plan entitySingle employer plan
2019-09-01Plan funding arrangement – InsuranceYes
2019-09-01Plan benefit arrangement – InsuranceYes
2018: THE LUTHERAN HOME ASSOCIATION VISION BENEFITS PLAN 2018 form 5500 responses
2018-09-01Type of plan entitySingle employer plan
2018-09-01Plan funding arrangement – InsuranceYes
2018-09-01Plan benefit arrangement – InsuranceYes
2017: THE LUTHERAN HOME ASSOCIATION VISION BENEFITS PLAN 2017 form 5500 responses
2017-09-01Type of plan entitySingle employer plan
2017-09-01Plan funding arrangement – InsuranceYes
2017-09-01Plan benefit arrangement – InsuranceYes
2016: THE LUTHERAN HOME ASSOCIATION VISION BENEFITS PLAN 2016 form 5500 responses
2016-09-01Type of plan entitySingle employer plan
2016-09-01Submission has been amendedNo
2016-09-01This submission is the final filingNo
2016-09-01This return/report is a short plan year return/report (less than 12 months)No
2016-09-01Plan is a collectively bargained planNo
2016-09-01Plan funding arrangement – InsuranceYes
2016-09-01Plan benefit arrangement – InsuranceYes
2015: THE LUTHERAN HOME ASSOCIATION VISION BENEFITS PLAN 2015 form 5500 responses
2015-09-01Type of plan entitySingle employer plan
2015-09-01First time form 5500 has been submittedYes
2015-09-01Submission has been amendedNo
2015-09-01This submission is the final filingNo
2015-09-01This return/report is a short plan year return/report (less than 12 months)No
2015-09-01Plan is a collectively bargained planNo
2015-09-01Plan funding arrangement – InsuranceYes
2015-09-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number10044231001
Policy instance 1
Insurance contract or identification number10044231001
Number of Individuals Covered311
Insurance policy start date2021-09-01
Insurance policy end date2022-08-31
Total amount of commissions paid to insurance brokerUSD $2,308
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $12,194
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,308
Amount paid for insurance broker fees0
Insurance broker organization code?3
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number10044231001
Policy instance 1
Insurance contract or identification number10044231001
Number of Individuals Covered193
Insurance policy start date2020-09-01
Insurance policy end date2021-08-31
Total amount of commissions paid to insurance brokerUSD $2,425
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $14,743
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,425
Amount paid for insurance broker fees0
Insurance broker organization code?3
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number10044231001
Policy instance 1
Insurance contract or identification number10044231001
Number of Individuals Covered199
Insurance policy start date2019-09-01
Insurance policy end date2020-08-31
Total amount of commissions paid to insurance brokerUSD $3,021
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $16,785
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,021
Amount paid for insurance broker fees0
Insurance broker organization code?3
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number10044231001
Policy instance 1
Insurance contract or identification number10044231001
Number of Individuals Covered197
Insurance policy start date2018-09-01
Insurance policy end date2019-08-31
Total amount of commissions paid to insurance brokerUSD $1,950
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $10,869
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,950
Amount paid for insurance broker fees0
Insurance broker organization code?3
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number10044231001
Policy instance 1
Insurance contract or identification number10044231001
Number of Individuals Covered173
Insurance policy start date2017-09-01
Insurance policy end date2018-08-31
Total amount of commissions paid to insurance brokerUSD $2,145
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $11,962
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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