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BREWSTER PLACE WELFARE BENEFIT PLAN 401k Plan overview

Plan NameBREWSTER PLACE WELFARE BENEFIT PLAN
Plan identification number 502

BREWSTER PLACE WELFARE BENEFIT PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Life insurance
  • Temporary disability (accident and sickness)
  • Long-term disability cover
  • Death benefits (include travel accident but not life insurance)
  • Other welfare benefit cover

401k Sponsoring company profile

THE CONGREGATIONAL HOME DBA BREWSTER PLACE has sponsored the creation of one or more 401k plans.

Company Name:THE CONGREGATIONAL HOME DBA BREWSTER PLACE
Employer identification number (EIN):480669554
NAIC Classification:623000
NAIC Description: Nursing and Residential Care Facilities

Form 5500 Filing Information

Submission information for form 5500 for 401k plan BREWSTER PLACE WELFARE BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5022022-01-01
5022021-01-01
5022020-01-01
5022019-01-01
5022018-01-01LARRY RIGGINS WALTER J. EWERT2019-07-25
5022017-01-01LARRY RIGGINS DAVID BECK2018-08-15
5022016-01-01LARRY RIGGINS DAVID BECK2017-07-31
5022015-01-01LARRY RIGGINS DAVID BECK2016-10-07
5022014-01-01LARRY RIGGINS DAVID BECK2015-07-15
5022013-01-01LARRY RIGGINS DAVID BECK2014-04-24
5022012-01-01LARRY RIGGINS DAVID BECK2014-04-24
5022011-01-01LARRY RIGGINS DAVID BECK2012-08-16
5022009-01-01LARRY RIGGINS DAVID BECK2010-09-20

Plan Statistics for BREWSTER PLACE WELFARE BENEFIT PLAN

401k plan membership statisitcs for BREWSTER PLACE WELFARE BENEFIT PLAN

Measure Date Value
2022: BREWSTER PLACE WELFARE BENEFIT PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-01177
Total number of active participants reported on line 7a of the Form 55002022-01-01174
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 participants2022-01-01174
2021: BREWSTER PLACE WELFARE BENEFIT PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-01175
Total number of active participants reported on line 7a of the Form 55002021-01-01177
Number of retired or separated participants receiving benefits2021-01-010
Number of other retired or separated participants entitled to future benefits2021-01-010
Total of all active and inactive participants2021-01-01177
2020: BREWSTER PLACE WELFARE BENEFIT PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-01177
Total number of active participants reported on line 7a of the Form 55002020-01-01175
Total of all active and inactive participants2020-01-01175
2019: BREWSTER PLACE WELFARE BENEFIT PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-01189
Total number of active participants reported on line 7a of the Form 55002019-01-01177
Total of all active and inactive participants2019-01-01177
2018: BREWSTER PLACE WELFARE BENEFIT PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-01191
Total number of active participants reported on line 7a of the Form 55002018-01-01189
Total of all active and inactive participants2018-01-01189
2017: BREWSTER PLACE WELFARE BENEFIT PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-01188
Total number of active participants reported on line 7a of the Form 55002017-01-01191
Total of all active and inactive participants2017-01-01191
2016: BREWSTER PLACE WELFARE BENEFIT PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-01184
Total number of active participants reported on line 7a of the Form 55002016-01-01188
Total of all active and inactive participants2016-01-01188
2015: BREWSTER PLACE WELFARE BENEFIT PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-01180
Total number of active participants reported on line 7a of the Form 55002015-01-01184
Total of all active and inactive participants2015-01-01184
2014: BREWSTER PLACE WELFARE BENEFIT PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-01174
Total number of active participants reported on line 7a of the Form 55002014-01-01180
Total of all active and inactive participants2014-01-01180
2013: BREWSTER PLACE WELFARE BENEFIT PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-01197
Total number of active participants reported on line 7a of the Form 55002013-01-01174
Total of all active and inactive participants2013-01-01174
2012: BREWSTER PLACE WELFARE BENEFIT PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-01177
Total number of active participants reported on line 7a of the Form 55002012-01-01194
Total of all active and inactive participants2012-01-01194
2011: BREWSTER PLACE WELFARE BENEFIT PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-01156
Total number of active participants reported on line 7a of the Form 55002011-01-01177
Total of all active and inactive participants2011-01-01177
2009: BREWSTER PLACE WELFARE BENEFIT PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-01179
Total number of active participants reported on line 7a of the Form 55002009-01-01171
Total of all active and inactive participants2009-01-01171

Form 5500 Responses for BREWSTER PLACE WELFARE BENEFIT PLAN

2022: BREWSTER PLACE WELFARE BENEFIT 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 benefit arrangement – InsuranceYes
2021: BREWSTER PLACE WELFARE BENEFIT PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Submission has been amendedNo
2021-01-01This submission is the final filingNo
2021-01-01This return/report is a short plan year return/report (less than 12 months)No
2021-01-01Plan is a collectively bargained planNo
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan benefit arrangement – InsuranceYes
2020: BREWSTER PLACE WELFARE BENEFIT PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan benefit arrangement – InsuranceYes
2019: BREWSTER PLACE WELFARE BENEFIT PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan benefit arrangement – InsuranceYes
2018: BREWSTER PLACE WELFARE BENEFIT PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan benefit arrangement – InsuranceYes
2017: BREWSTER PLACE WELFARE BENEFIT PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan benefit arrangement – InsuranceYes
2016: BREWSTER PLACE WELFARE BENEFIT PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan benefit arrangement – InsuranceYes
2015: BREWSTER PLACE WELFARE BENEFIT PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan benefit arrangement – InsuranceYes
2014: BREWSTER PLACE WELFARE BENEFIT PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan benefit arrangement – InsuranceYes
2013: BREWSTER PLACE WELFARE BENEFIT PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan benefit arrangement – InsuranceYes
2012: BREWSTER PLACE WELFARE BENEFIT PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Submission has been amendedYes
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan benefit arrangement – InsuranceYes
2011: BREWSTER PLACE WELFARE BENEFIT PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan benefit arrangement – InsuranceYes
2009: BREWSTER PLACE WELFARE BENEFIT PLAN 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01This submission is the final filingNo
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

MADISON NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65781 )
Policy contract number7900-154
Policy instance 2
Insurance contract or identification number7900-154
Number of Individuals Covered133
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $4,761
Total amount of fees paid to insurance companyUSD $6,007
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedA D & D
Welfare Benefit Premiums Paid to CarrierUSD $41,424
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,761
Insurance broker organization code?3
Amount paid for insurance broker fees2980
Additional information about fees paid to insurance brokerOVERRIDES
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number919453
Policy instance 1
Insurance contract or identification number919453
Number of Individuals Covered100
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $7,932
Total amount of fees paid to insurance companyUSD $1,859
Other welfare benefits providedACCIDENT INSURANCE, CRITICAL ILLNESS, VOLUNTARY LIFE, VOLUNTARY A D & D
Welfare Benefit Premiums Paid to CarrierUSD $32,552
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,932
Amount paid for insurance broker fees1859
Additional information about fees paid to insurance brokerBONUS AMOUNT
Insurance broker organization code?3
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number919453
Policy instance 2
Insurance contract or identification number919453
Number of Individuals Covered99
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $7,992
Total amount of fees paid to insurance companyUSD $1,032
Other welfare benefits providedACCIDENT INSURANCE, CRITICAL ILLNESS, VOLUNTARY LIFE, VOLUNTARY A D & D
Welfare Benefit Premiums Paid to CarrierUSD $35,333
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,992
Amount paid for insurance broker fees1032
Additional information about fees paid to insurance brokerBONUS AMOUNT
Insurance broker organization code?3
MADISON NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65781 )
Policy contract number7900-154-MNL
Policy instance 1
Insurance contract or identification number7900-154-MNL
Number of Individuals Covered166
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $6,041
Total amount of fees paid to insurance companyUSD $7,604
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedA D & D
Welfare Benefit Premiums Paid to CarrierUSD $49,631
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,041
Insurance broker organization code?3
Amount paid for insurance broker fees3608
Additional information about fees paid to insurance brokerOVERRIDES
MADISON NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65781 )
Policy contract number7900-154-MNL
Policy instance 2
Insurance contract or identification number7900-154-MNL
Number of Individuals Covered175
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $6,041
Total amount of fees paid to insurance companyUSD $7,848
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $51,196
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,041
Insurance broker organization code?3
Amount paid for insurance broker fees4120
Additional information about fees paid to insurance brokerTPA FEES
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number919453
Policy instance 1
Insurance contract or identification number919453
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $7,919
Total amount of fees paid to insurance companyUSD $1,490
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D, CRITICAL ILLNESS, VOL LIFE
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,919
Amount paid for insurance broker fees1490
Additional information about fees paid to insurance brokerSALES AND SERVICE
Insurance broker organization code?3
MADISON NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65781 )
Policy contract number7900-154-MNL
Policy instance 2
Insurance contract or identification number7900-154-MNL
Number of Individuals Covered177
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $6,085
Total amount of fees paid to insurance companyUSD $7,962
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $51,799
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,085
Insurance broker organization code?3
Amount paid for insurance broker fees4140
Additional information about fees paid to insurance brokerTPA FEES
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number919453
Policy instance 1
Insurance contract or identification number919453
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $8,365
Total amount of fees paid to insurance companyUSD $1,600
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D, CRITICAL ILLNESS, VOL LIFE
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,365
Amount paid for insurance broker fees1600
Additional information about fees paid to insurance brokerSALES AND SERVICE
Insurance broker organization code?3
MADISON NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65781 )
Policy contract number7900-154-MNL
Policy instance 2
Insurance contract or identification number7900-154-MNL
Number of Individuals Covered189
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $6,486
Total amount of fees paid to insurance companyUSD $8,901
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability 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 $6,486
Insurance broker organization code?3
Amount paid for insurance broker fees4589
Additional information about fees paid to insurance brokerTPA FEES
COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 )
Policy contract numberE4044251
Policy instance 1
Insurance contract or identification numberE4044251
Number of Individuals Covered77
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $9,536
Total amount of fees paid to insurance companyUSD $949
Life 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 $4,905
Insurance broker organization code?3
Amount paid for insurance broker fees141
MADISON NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65781 )
Policy contract number7900-154-MNL
Policy instance 2
Insurance contract or identification number7900-154-MNL
Number of Individuals Covered191
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $5,395
Total amount of fees paid to insurance companyUSD $7,797
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability 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 $5,395
Insurance broker organization code?3
Amount paid for insurance broker fees4051
Additional information about fees paid to insurance brokerOVERRIDING COMMISSIONS
Insurance broker nameNORTH AMERICAN BENEFITS COMPANY
COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 )
Policy contract numberE4044251
Policy instance 1
Insurance contract or identification numberE4044251
Number of Individuals Covered79
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $9,957
Total amount of fees paid to insurance companyUSD $517
Life 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 $4,969
Insurance broker organization code?3
Amount paid for insurance broker fees165
Additional information about fees paid to insurance brokerSALES AND SERVICE
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
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedHOSPITAL CONFINEMENT, ACCIDENT, CRITICAL CARE AND CANCER
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Insurance broker nameDALE T BUTLER

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