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BLESSINGS 4 EVER HOME CARE AGENCY LLC EMPLOYEE BENEFITS HEALTH & WELFARE PLAN 401k Plan overview

Plan NameBLESSINGS 4 EVER HOME CARE AGENCY LLC EMPLOYEE BENEFITS HEALTH & WELFARE PLAN
Plan identification number 501

BLESSINGS 4 EVER HOME CARE AGENCY LLC EMPLOYEE BENEFITS HEALTH & WELFARE PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Dental
  • Vision

401k Sponsoring company profile

BLESSINGS4EVER HOME CARE AGENCY LLC has sponsored the creation of one or more 401k plans.

Company Name:BLESSINGS4EVER HOME CARE AGENCY LLC
Employer identification number (EIN):461522980
NAIC Classification:623000
NAIC Description: Nursing and Residential Care Facilities

Form 5500 Filing Information

Submission information for form 5500 for 401k plan BLESSINGS 4 EVER HOME CARE AGENCY LLC EMPLOYEE BENEFITS HEALTH & WELFARE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012022-01-01
5012021-02-01PERCY NARANJO2022-08-31
5012020-02-01DINA DELLA DUCATA2021-08-25
5012019-02-01MELISSA ALLEN2020-06-25
5012018-02-01MELISSA ALLEN2019-10-02

Plan Statistics for BLESSINGS 4 EVER HOME CARE AGENCY LLC EMPLOYEE BENEFITS HEALTH & WELFARE PLAN

401k plan membership statisitcs for BLESSINGS 4 EVER HOME CARE AGENCY LLC EMPLOYEE BENEFITS HEALTH & WELFARE PLAN

Measure Date Value
2022: BLESSINGS 4 EVER HOME CARE AGENCY LLC EMPLOYEE BENEFITS HEALTH & WELFARE PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-01218
Total number of active participants reported on line 7a of the Form 55002022-01-01185
Number of retired or separated participants receiving benefits2022-01-010
Number of other retired or separated participants entitled to future benefits2022-01-010
Total of all active and inactive participants2022-01-01185
2021: BLESSINGS 4 EVER HOME CARE AGENCY LLC EMPLOYEE BENEFITS HEALTH & WELFARE PLAN 2021 401k membership
Total participants, beginning-of-year2021-02-01174
Total number of active participants reported on line 7a of the Form 55002021-02-01138
Number of retired or separated participants receiving benefits2021-02-010
Number of other retired or separated participants entitled to future benefits2021-02-010
Total of all active and inactive participants2021-02-01138
Number of employers contributing to the scheme2021-02-010
2020: BLESSINGS 4 EVER HOME CARE AGENCY LLC EMPLOYEE BENEFITS HEALTH & WELFARE PLAN 2020 401k membership
Total participants, beginning-of-year2020-02-01232
Total number of active participants reported on line 7a of the Form 55002020-02-01218
Number of retired or separated participants receiving benefits2020-02-010
Number of other retired or separated participants entitled to future benefits2020-02-010
Total of all active and inactive participants2020-02-01218
Number of employers contributing to the scheme2020-02-010
2019: BLESSINGS 4 EVER HOME CARE AGENCY LLC EMPLOYEE BENEFITS HEALTH & WELFARE PLAN 2019 401k membership
Total participants, beginning-of-year2019-02-01197
Total number of active participants reported on line 7a of the Form 55002019-02-01242
Number of retired or separated participants receiving benefits2019-02-010
Number of other retired or separated participants entitled to future benefits2019-02-010
Total of all active and inactive participants2019-02-01242
Number of employers contributing to the scheme2019-02-010
2018: BLESSINGS 4 EVER HOME CARE AGENCY LLC EMPLOYEE BENEFITS HEALTH & WELFARE PLAN 2018 401k membership
Total participants, beginning-of-year2018-02-01100
Total number of active participants reported on line 7a of the Form 55002018-02-01187
Number of retired or separated participants receiving benefits2018-02-010
Number of other retired or separated participants entitled to future benefits2018-02-010
Total of all active and inactive participants2018-02-01187
Number of employers contributing to the scheme2018-02-010

Form 5500 Responses for BLESSINGS 4 EVER HOME CARE AGENCY LLC EMPLOYEE BENEFITS HEALTH & WELFARE PLAN

2022: BLESSINGS 4 EVER HOME CARE AGENCY LLC EMPLOYEE BENEFITS HEALTH & WELFARE PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Submission has been amendedNo
2022-01-01This submission is the final filingNo
2022-01-01This return/report is a short plan year return/report (less than 12 months)No
2022-01-01Plan is a collectively bargained planNo
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan funding arrangement – General assets of the sponsorYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement – General assets of the sponsorYes
2021: BLESSINGS 4 EVER HOME CARE AGENCY LLC EMPLOYEE BENEFITS HEALTH & WELFARE PLAN 2021 form 5500 responses
2021-02-01Type of plan entitySingle employer plan
2021-02-01Plan funding arrangement – InsuranceYes
2021-02-01Plan funding arrangement – General assets of the sponsorYes
2021-02-01Plan benefit arrangement – InsuranceYes
2021-02-01Plan benefit arrangement – General assets of the sponsorYes
2020: BLESSINGS 4 EVER HOME CARE AGENCY LLC EMPLOYEE BENEFITS HEALTH & WELFARE PLAN 2020 form 5500 responses
2020-02-01Type of plan entitySingle employer plan
2020-02-01Plan funding arrangement – InsuranceYes
2020-02-01Plan funding arrangement – General assets of the sponsorYes
2020-02-01Plan benefit arrangement – InsuranceYes
2020-02-01Plan benefit arrangement – General assets of the sponsorYes
2019: BLESSINGS 4 EVER HOME CARE AGENCY LLC EMPLOYEE BENEFITS HEALTH & WELFARE PLAN 2019 form 5500 responses
2019-02-01Type of plan entitySingle employer plan
2019-02-01Plan funding arrangement – InsuranceYes
2019-02-01Plan funding arrangement – General assets of the sponsorYes
2019-02-01Plan benefit arrangement – InsuranceYes
2019-02-01Plan benefit arrangement – General assets of the sponsorYes
2018: BLESSINGS 4 EVER HOME CARE AGENCY LLC EMPLOYEE BENEFITS HEALTH & WELFARE PLAN 2018 form 5500 responses
2018-02-01Type of plan entitySingle employer plan
2018-02-01First time form 5500 has been submittedYes
2018-02-01Plan funding arrangement – InsuranceYes
2018-02-01Plan funding arrangement – General assets of the sponsorYes
2018-02-01Plan benefit arrangement – InsuranceYes
2018-02-01Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

HM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93440 )
Policy contract number407721
Policy instance 1
Insurance contract or identification number407721
Number of Individuals Covered185
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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 CarrierUSD $266,478
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number10322321001
Policy instance 3
Insurance contract or identification number10322321001
Number of Individuals Covered195
Insurance policy start date2021-02-01
Insurance policy end date2022-01-31
Total amount of commissions paid to insurance brokerUSD $1,610
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $9,879
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,610
Amount paid for insurance broker fees0
Insurance broker organization code?3
UNITED CONCORDIA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 85766 )
Policy contract numberA10422-000
Policy instance 2
Insurance contract or identification numberA10422-000
Number of Individuals Covered200
Insurance policy start date2021-10-01
Insurance policy end date2022-01-31
Total amount of commissions paid to insurance brokerUSD $2,801
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $22,098
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $2,801
Amount paid for insurance broker fees0
Insurance broker organization code?3
UNITED CONCORDIA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 85766 )
Policy contract numberA10422-000
Policy instance 1
Insurance contract or identification numberA10422-000
Number of Individuals Covered169
Insurance policy start date2020-10-01
Insurance policy end date2021-09-30
Total amount of commissions paid to insurance brokerUSD $8,280
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $69,027
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $8,280
Amount paid for insurance broker fees0
Insurance broker organization code?3
UNITED CONCORDIA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 85766 )
Policy contract numberA10422-000
Policy instance 2
Insurance contract or identification numberA10422-000
Number of Individuals Covered200
Insurance policy start date2019-10-01
Insurance policy end date2020-09-30
Total amount of commissions paid to insurance brokerUSD $8,181
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $75,926
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,181
Amount paid for insurance broker fees0
Insurance broker organization code?3
INDEPENDENCE BLUE CROSS (National Association of Insurance Commissioners NAIC id number: 93688 )
Policy contract number2035982
Policy instance 1
Insurance contract or identification number2035982
Number of Individuals Covered246
Insurance policy start date2020-02-01
Insurance policy end date2021-01-31
Total amount of commissions paid to insurance brokerUSD $74,083
Total amount of fees paid to insurance companyUSD $6,214
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $74,083
Amount paid for insurance broker fees6214
Additional information about fees paid to insurance brokerOVERRIDE NON-MONETARY COMPENSATION
Insurance broker organization code?3
UNITED CONCORDIA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 85766 )
Policy contract numberA10422-000
Policy instance 2
Insurance contract or identification numberA10422-000
Number of Individuals Covered123
Insurance policy start date2018-10-01
Insurance policy end date2019-09-30
Total amount of commissions paid to insurance brokerUSD $8,811
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $61,381
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $8,811
Insurance broker organization code?3
INDEPENDENCE BLUE CROSS (National Association of Insurance Commissioners NAIC id number: 93688 )
Policy contract number2035982
Policy instance 1
Insurance contract or identification number2035982
Number of Individuals Covered241
Insurance policy start date2019-02-01
Insurance policy end date2020-01-31
Total amount of commissions paid to insurance brokerUSD $104,108
Total amount of fees paid to insurance companyUSD $9,634
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $104,108
Amount paid for insurance broker fees9634
Additional information about fees paid to insurance brokerOVERRIDE NON MONETARY COMMISSIONS
Insurance broker organization code?3
AEGIS SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 33898 )
Policy contract numberGP-PA0403
Policy instance 3
Insurance contract or identification numberGP-PA0403
Number of Individuals Covered215
Insurance policy start date2018-02-01
Insurance policy end date2019-01-31
Total amount of commissions paid to insurance brokerUSD $25,021
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedGAP
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $14,596
Amount paid for insurance broker fees0
Insurance broker organization code?3
UNITED CONCORDIA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 85766 )
Policy contract numberA10422000
Policy instance 2
Insurance contract or identification numberA10422000
Number of Individuals Covered11
Insurance policy start date2017-10-01
Insurance policy end date2018-09-30
Total amount of commissions paid to insurance brokerUSD $2,172
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $17,638
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $2,172
Amount paid for insurance broker fees0
Insurance broker organization code?3
INDEPENDENCE BLUE CROSS (National Association of Insurance Commissioners NAIC id number: 93688 )
Policy contract number2035982
Policy instance 1
Insurance contract or identification number2035982
Number of Individuals Covered219
Insurance policy start date2018-02-01
Insurance policy end date2019-01-31
Total amount of commissions paid to insurance brokerUSD $64,244
Total amount of fees paid to insurance companyUSD $28,457
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $64,244
Amount paid for insurance broker fees28457
Additional information about fees paid to insurance brokerOVERRIDE NON-MONETARY COMMISSIONS
Insurance broker organization code?3

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