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ELITE MEDICAL WELFARE PLAN 401k Plan overview

Plan NameELITE MEDICAL WELFARE PLAN
Plan identification number 501

ELITE MEDICAL WELFARE PLAN Benefits

401k Plan TypeWelfare 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

ELITE- MEDICAL, LLC has sponsored the creation of one or more 401k plans.

Company Name:ELITE- MEDICAL, LLC
Employer identification number (EIN):472251368
NAIC Classification:339110

Form 5500 Filing Information

Submission information for form 5500 for 401k plan ELITE MEDICAL WELFARE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012023-09-01ALICIA GRAHAM2025-01-09
5012022-09-01ALICIA GRAHAM2024-02-12
5012021-09-01
5012021-09-01GARRETT SMITH
5012020-09-01

Plan Statistics for ELITE MEDICAL WELFARE PLAN

401k plan membership statisitcs for ELITE MEDICAL WELFARE PLAN

Measure Date Value
2023: ELITE MEDICAL WELFARE PLAN 2023 401k membership
Total participants, beginning-of-year2023-09-01165
Total number of active participants reported on line 7a of the Form 55002023-09-01297
Number of retired or separated participants receiving benefits2023-09-010
Number of other retired or separated participants entitled to future benefits2023-09-010
Total of all active and inactive participants2023-09-01297
Number of employers contributing to the scheme2023-09-010
2022: ELITE MEDICAL WELFARE PLAN 2022 401k membership
Total participants, beginning-of-year2022-09-01147
Total number of active participants reported on line 7a of the Form 55002022-09-01165
Number of retired or separated participants receiving benefits2022-09-010
Number of other retired or separated participants entitled to future benefits2022-09-010
Total of all active and inactive participants2022-09-01165
Number of employers contributing to the scheme2022-09-010
2021: ELITE MEDICAL WELFARE PLAN 2021 401k membership
Total participants, beginning-of-year2021-09-01126
Total number of active participants reported on line 7a of the Form 55002021-09-01147
Total of all active and inactive participants2021-09-01147
Total participants2021-09-01147
2020: ELITE MEDICAL WELFARE PLAN 2020 401k membership
Total participants, beginning-of-year2020-09-01110
Total number of active participants reported on line 7a of the Form 55002020-09-01118
Number of retired or separated participants receiving benefits2020-09-010
Number of other retired or separated participants entitled to future benefits2020-09-010
Total of all active and inactive participants2020-09-01118
Total participants2020-09-01118

Form 5500 Responses for ELITE MEDICAL WELFARE PLAN

2023: ELITE MEDICAL WELFARE PLAN 2023 form 5500 responses
2023-09-01Type of plan entitySingle employer plan
2023-09-01Plan funding arrangement – InsuranceYes
2023-09-01Plan benefit arrangement – InsuranceYes
2022: ELITE MEDICAL WELFARE PLAN 2022 form 5500 responses
2022-09-01Type of plan entitySingle employer plan
2022-09-01Plan funding arrangement – InsuranceYes
2022-09-01Plan benefit arrangement – InsuranceYes
2021: ELITE MEDICAL WELFARE PLAN 2021 form 5500 responses
2021-09-01Type of plan entitySingle employer plan
2021-09-01Submission has been amendedNo
2021-09-01This submission is the final filingNo
2021-09-01This return/report is a short plan year return/report (less than 12 months)No
2021-09-01Plan is a collectively bargained planNo
2021-09-01Plan funding arrangement – InsuranceYes
2021-09-01Plan funding arrangement – General assets of the sponsorYes
2021-09-01Plan benefit arrangement – InsuranceYes
2020: ELITE MEDICAL WELFARE PLAN 2020 form 5500 responses
2020-09-01Type of plan entitySingle employer plan
2020-09-01First time form 5500 has been submittedYes
2020-09-01Submission has been amendedNo
2020-09-01This submission is the final filingNo
2020-09-01This return/report is a short plan year return/report (less than 12 months)No
2020-09-01Plan is a collectively bargained planNo
2020-09-01Plan funding arrangement – InsuranceYes
2020-09-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract number10-057141
Policy instance 1
Insurance contract or identification number10-057141
Number of Individuals Covered404
Insurance policy start date2023-09-01
Insurance policy end date2024-08-31
Total amount of commissions paid to insurance brokerUSD $10,536
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $105,357
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BLUECROSS BLUESHIELD OF TENNESSEE, INC. (National Association of Insurance Commissioners NAIC id number: 54518 )
Policy contract number123108
Policy instance 2
Insurance contract or identification number123108
Number of Individuals Covered265
Insurance policy start date2023-09-01
Insurance policy end date2024-08-31
Total amount of commissions paid to insurance brokerUSD $63,893
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,137,220
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number947488
Policy instance 3
Insurance contract or identification number947488
Number of Individuals Covered297
Insurance policy start date2023-09-01
Insurance policy end date2024-08-31
Total amount of commissions paid to insurance brokerUSD $13,386
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT, HOSPITAL
Welfare Benefit Premiums Paid to CarrierUSD $135,087
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract number010-057141
Policy instance 1
BLUECROSS BLUESHIELD OF TENNESSEE, INC. (National Association of Insurance Commissioners NAIC id number: 54518 )
Policy contract number123108
Policy instance 2
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number947488
Policy instance 3
BLUECROSS BLUESHIELD OF TENNESSEE, INC. (National Association of Insurance Commissioners NAIC id number: 54518 )
Policy contract number123108
Policy instance 1
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract number010-057141
Policy instance 2
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number947488
Policy instance 3

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