401k Plan data: LANDSCAPES UNLIMITED, LLC HEALTH AND WELFARE PLAN plan

LANDSCAPES UNLIMITED, LLC HEALTH AND WELFARE PLAN 401k Plan overview

Plan Name	LANDSCAPES UNLIMITED, LLC HEALTH AND WELFARE PLAN
Plan identification number	507

LANDSCAPES UNLIMITED, LLC HEALTH AND WELFARE PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) Life insurance Dental Vision Temporary disability (accident and sickness) Long-term disability cover Death benefits (include travel accident but not life insurance)

401k Sponsoring company profile

LANDSCAPES UNLIMITED, LLC has sponsored the creation of one or more 401k plans.

Company Name: LANDSCAPES UNLIMITED, LLC

Employer identification number (EIN): 470822871

NAIC Classification: 237990
NAIC Description: Other Heavy and Civil Engineering Construction

Form 5500 Filing Information

Submission information for form 5500 for 401k plan LANDSCAPES UNLIMITED, LLC HEALTH AND WELFARE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
507 2023-01-01 BRYCE JUEDES 2024-05-30
507 2022-01-01
507 2022-01-01 BRYCE JUEDES

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
507	2023-01-01	BRYCE JUEDES	2024-05-30
507	2022-01-01
507	2022-01-01	BRYCE JUEDES

Form 5500 Responses for LANDSCAPES UNLIMITED, LLC HEALTH AND WELFARE PLAN

2023: LANDSCAPES UNLIMITED, LLC HEALTH AND WELFARE PLAN 2023 form 5500 responses
2023-01-01	Type of plan entity	Single employer plan
2023-01-01	Plan funding arrangement – Insurance	Yes
2023-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2023-01-01	Plan benefit arrangement – Insurance	Yes
2023-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2022: LANDSCAPES UNLIMITED, LLC HEALTH AND WELFARE PLAN 2022 form 5500 responses
2022-01-01	Type of plan entity	Single employer plan
2022-01-01	Plan funding arrangement – Insurance	Yes
2022-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2022-01-01	Plan benefit arrangement – Insurance	Yes
2022-01-01	Plan benefit arrangement – General assets of the sponsor	Yes

Insurance Providers Used on plan

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

400001000 05498

Policy instance

Insurance contract or identification number	400001000 05498
Number of Individuals Covered	239
Insurance policy start date	2023-01-01
Insurance policy end date	2023-12-31
Total amount of commissions paid to insurance broker	USD $12,963
Total amount of fees paid to insurance company	USD $573
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to Carrier	USD $86,418
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )

Policy contract number

GUPR0ATQW

Policy instance

Insurance contract or identification number	GUPR0ATQW
Number of Individuals Covered	178
Insurance policy start date	2023-01-01
Insurance policy end date	2023-12-31
Total amount of commissions paid to insurance broker	USD $8,531
Total amount of fees paid to insurance company	USD $3,549
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Unemployment Insurance Welfare Benefit	No
Welfare Benefit Premiums Paid to Carrier	USD $127,228
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )

Policy contract number

GUPR0ATQW

Policy instance

Insurance contract or identification number	GUPR0ATQW
Number of Individuals Covered	165
Insurance policy start date	2022-01-01
Insurance policy end date	2023-01-01
Total amount of commissions paid to insurance broker	USD $4,747
Total amount of fees paid to insurance company	USD $2,404
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $74,657
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

040000100005498

Policy instance

Insurance contract or identification number	040000100005498
Number of Individuals Covered	323
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $11,462
Total amount of fees paid to insurance company	USD $465
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	VOLUNTARY AD&D
Welfare Benefit Premiums Paid to Carrier	USD $76,412
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )

Policy contract number

G000ATQW

Policy instance

Insurance contract or identification number	G000ATQW
Number of Individuals Covered	110
Insurance policy start date	2022-01-01
Insurance policy end date	2023-01-01
Total amount of commissions paid to insurance broker	USD $3,247
Total amount of fees paid to insurance company	USD $883
Temporary Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $34,942
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

Potentially related plans

LANDSCAPES UNLIMITED, INC. 401(K) PROFIT SHARING PLAN [EIN = 201297323]

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Company Name:	LANDSCAPES UNLIMITED, LLC
Employer identification number (EIN):	470822871
NAIC Classification:	237990
NAIC Description:	Other Heavy and Civil Engineering Construction