401k Plan data: PRESCRIPTION LANDSCAPE LIFE INSURANCE PLAN plan

PRESCRIPTION LANDSCAPE LIFE INSURANCE PLAN 401k Plan overview

Plan Name	PRESCRIPTION LANDSCAPE LIFE INSURANCE PLAN
Plan identification number	503

PRESCRIPTION LANDSCAPE LIFE INSURANCE PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Life insurance Death benefits (include travel accident but not life insurance) 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.

401k Sponsoring company profile

PRESCRIPTION LANDSCAPE has sponsored the creation of one or more 401k plans.

Company Name: PRESCRIPTION LANDSCAPE

Employer identification number (EIN): 411516151

NAIC Classification: 561730
NAIC Description: Landscaping Services

Form 5500 Filing Information

Submission information for form 5500 for 401k plan PRESCRIPTION LANDSCAPE LIFE INSURANCE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
503 2021-07-01
503 2020-07-01
503 2020-07-01

Plan Statistics for PRESCRIPTION LANDSCAPE LIFE INSURANCE PLAN

401k plan membership statisitcs for PRESCRIPTION LANDSCAPE LIFE INSURANCE PLAN

Measure Date Value
2021: PRESCRIPTION LANDSCAPE LIFE INSURANCE PLAN 2021 401k membership
Total participants, beginning-of-year 2021-07-01 120
Total number of active participants reported on line 7a of the Form 5500 2021-07-01 98
Number of retired or separated participants receiving benefits 2021-07-01 0
Number of other retired or separated participants entitled to future benefits 2021-07-01 3
Total of all active and inactive participants 2021-07-01 101
2020: PRESCRIPTION LANDSCAPE LIFE INSURANCE PLAN 2020 401k membership
Total participants, beginning-of-year 2020-07-01 129
Total number of active participants reported on line 7a of the Form 5500 2020-07-01 0
Number of retired or separated participants receiving benefits 2020-07-01 0
Number of other retired or separated participants entitled to future benefits 2020-07-01 0
Total of all active and inactive participants 2020-07-01 0

Measure	Date	Value
2021: PRESCRIPTION LANDSCAPE LIFE INSURANCE PLAN 2021 401k membership
Total participants, beginning-of-year	2021-07-01	120
Total number of active participants reported on line 7a of the Form 5500	2021-07-01	98
Number of retired or separated participants receiving benefits	2021-07-01	0
Number of other retired or separated participants entitled to future benefits	2021-07-01	3
Total of all active and inactive participants	2021-07-01	101
2020: PRESCRIPTION LANDSCAPE LIFE INSURANCE PLAN 2020 401k membership
Total participants, beginning-of-year	2020-07-01	129
Total number of active participants reported on line 7a of the Form 5500	2020-07-01	0
Number of retired or separated participants receiving benefits	2020-07-01	0
Number of other retired or separated participants entitled to future benefits	2020-07-01	0
Total of all active and inactive participants	2020-07-01	0

Form 5500 Responses for PRESCRIPTION LANDSCAPE LIFE INSURANCE PLAN

2021: PRESCRIPTION LANDSCAPE LIFE INSURANCE PLAN 2021 form 5500 responses
2021-07-01	Type of plan entity	Single employer plan
2021-07-01	Submission has been amended	No
2021-07-01	This submission is the final filing	No
2021-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2021-07-01	Plan is a collectively bargained plan	No
2021-07-01	Plan funding arrangement – Insurance	Yes
2021-07-01	Plan benefit arrangement – Insurance	Yes
2020: PRESCRIPTION LANDSCAPE LIFE INSURANCE PLAN 2020 form 5500 responses
2020-07-01	Type of plan entity	Single employer plan
2020-07-01	First time form 5500 has been submitted	Yes
2020-07-01	Submission has been amended	No
2020-07-01	This submission is the final filing	Yes
2020-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2020-07-01	Plan is a collectively bargained plan	No
2020-07-01	Plan funding arrangement – Insurance	Yes
2020-07-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )

Policy contract number

1078421

Policy instance

Insurance contract or identification number	1078421
Number of Individuals Covered	99
Insurance policy start date	2021-07-01
Insurance policy end date	2022-06-30
Total amount of commissions paid to insurance broker	USD $1,025
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Welfare Benefit Premiums Paid to Carrier	USD $11,114
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,025
Insurance broker organization code?	3

PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )

Policy contract number

1078421

Policy instance

Insurance contract or identification number	1078421
Number of Individuals Covered	0
Insurance policy start date	2020-07-01
Insurance policy end date	2021-06-30
Total amount of commissions paid to insurance broker	USD $1,129
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Welfare Benefit Premiums Paid to Carrier	USD $14,463
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,129
Insurance broker organization code?	3

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Company Name:	PRESCRIPTION LANDSCAPE
Employer identification number (EIN):	411516151
NAIC Classification:	561730
NAIC Description:	Landscaping Services