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ARUNDEL LODGE, INC. LIFE AND ADD PLAN 401k Plan overview

Plan NameARUNDEL LODGE, INC. LIFE AND ADD PLAN
Plan identification number 501

ARUNDEL LODGE, INC. LIFE AND ADD PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Vision
  • Death benefits (include travel accident but not life insurance)
  • Other welfare benefit cover

401k Sponsoring company profile

ARUNDEL LODGE, INC. has sponsored the creation of one or more 401k plans.

Company Name:ARUNDEL LODGE, INC.
Employer identification number (EIN):510169423
NAIC Classification:621420
NAIC Description:Outpatient Mental Health and Substance Abuse Centers

Form 5500 Filing Information

Submission information for form 5500 for 401k plan ARUNDEL LODGE, INC. LIFE AND ADD PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012022-10-01JAMES BUCKEY2024-04-22
5012021-10-01JAMES E. BUCKEY2023-04-12
5012020-10-01JAMES E. BUCKEY2022-01-31
5012019-10-01JAMES E. BUCKEY2021-01-15
5012018-10-01JAMES BUCKEY2020-04-23
5012017-10-01JAMES BUCKEY2019-04-29
5012016-10-01
5012015-10-01JAMES E. BUCKEY JAMES E. BUCKEY2017-04-26

Plan Statistics for ARUNDEL LODGE, INC. LIFE AND ADD PLAN

401k plan membership statisitcs for ARUNDEL LODGE, INC. LIFE AND ADD PLAN

Measure Date Value
2022: ARUNDEL LODGE, INC. LIFE AND ADD PLAN 2022 401k membership
Total participants, beginning-of-year2022-10-01105
Total number of active participants reported on line 7a of the Form 55002022-10-01113
Number of retired or separated participants receiving benefits2022-10-010
Number of other retired or separated participants entitled to future benefits2022-10-010
Total of all active and inactive participants2022-10-01113
Number of employers contributing to the scheme2022-10-010
2021: ARUNDEL LODGE, INC. LIFE AND ADD PLAN 2021 401k membership
Total participants, beginning-of-year2021-10-01107
Total number of active participants reported on line 7a of the Form 55002021-10-01105
Number of retired or separated participants receiving benefits2021-10-010
Number of other retired or separated participants entitled to future benefits2021-10-010
Total of all active and inactive participants2021-10-01105
Number of employers contributing to the scheme2021-10-010
2020: ARUNDEL LODGE, INC. LIFE AND ADD PLAN 2020 401k membership
Total participants, beginning-of-year2020-10-01129
Total number of active participants reported on line 7a of the Form 55002020-10-01113
Number of retired or separated participants receiving benefits2020-10-010
Number of other retired or separated participants entitled to future benefits2020-10-010
Total of all active and inactive participants2020-10-01113
Number of employers contributing to the scheme2020-10-010
2019: ARUNDEL LODGE, INC. LIFE AND ADD PLAN 2019 401k membership
Total participants, beginning-of-year2019-10-01102
Total number of active participants reported on line 7a of the Form 55002019-10-01129
Number of retired or separated participants receiving benefits2019-10-010
Number of other retired or separated participants entitled to future benefits2019-10-010
Total of all active and inactive participants2019-10-01129
Number of employers contributing to the scheme2019-10-010
2018: ARUNDEL LODGE, INC. LIFE AND ADD PLAN 2018 401k membership
Total participants, beginning-of-year2018-10-01102
Total number of active participants reported on line 7a of the Form 55002018-10-01102
Number of retired or separated participants receiving benefits2018-10-010
Number of other retired or separated participants entitled to future benefits2018-10-010
Total of all active and inactive participants2018-10-01102
Number of employers contributing to the scheme2018-10-010
2017: ARUNDEL LODGE, INC. LIFE AND ADD PLAN 2017 401k membership
Total participants, beginning-of-year2017-10-01119
Total number of active participants reported on line 7a of the Form 55002017-10-01119
Number of retired or separated participants receiving benefits2017-10-010
Number of other retired or separated participants entitled to future benefits2017-10-010
Total of all active and inactive participants2017-10-01119
Number of employers contributing to the scheme2017-10-010
2016: ARUNDEL LODGE, INC. LIFE AND ADD PLAN 2016 401k membership
Total participants, beginning-of-year2016-10-01120
Total number of active participants reported on line 7a of the Form 55002016-10-01119
Number of retired or separated participants receiving benefits2016-10-010
Number of other retired or separated participants entitled to future benefits2016-10-010
Total of all active and inactive participants2016-10-01119
2015: ARUNDEL LODGE, INC. LIFE AND ADD PLAN 2015 401k membership
Total participants, beginning-of-year2015-10-01120
Total number of active participants reported on line 7a of the Form 55002015-10-01120
Number of retired or separated participants receiving benefits2015-10-010
Number of other retired or separated participants entitled to future benefits2015-10-010
Total of all active and inactive participants2015-10-01120

Form 5500 Responses for ARUNDEL LODGE, INC. LIFE AND ADD PLAN

2022: ARUNDEL LODGE, INC. LIFE AND ADD PLAN 2022 form 5500 responses
2022-10-01Type of plan entitySingle employer plan
2022-10-01Plan funding arrangement – InsuranceYes
2022-10-01Plan funding arrangement – General assets of the sponsorYes
2022-10-01Plan benefit arrangement – InsuranceYes
2022-10-01Plan benefit arrangement – General assets of the sponsorYes
2021: ARUNDEL LODGE, INC. LIFE AND ADD PLAN 2021 form 5500 responses
2021-10-01Type of plan entitySingle employer plan
2021-10-01Plan funding arrangement – InsuranceYes
2021-10-01Plan funding arrangement – General assets of the sponsorYes
2021-10-01Plan benefit arrangement – InsuranceYes
2021-10-01Plan benefit arrangement – General assets of the sponsorYes
2020: ARUNDEL LODGE, INC. LIFE AND ADD PLAN 2020 form 5500 responses
2020-10-01Type of plan entitySingle employer plan
2020-10-01Plan funding arrangement – InsuranceYes
2020-10-01Plan benefit arrangement – InsuranceYes
2019: ARUNDEL LODGE, INC. LIFE AND ADD PLAN 2019 form 5500 responses
2019-10-01Type of plan entitySingle employer plan
2019-10-01Plan funding arrangement – InsuranceYes
2019-10-01Plan benefit arrangement – InsuranceYes
2018: ARUNDEL LODGE, INC. LIFE AND ADD PLAN 2018 form 5500 responses
2018-10-01Type of plan entitySingle employer plan
2018-10-01Plan funding arrangement – InsuranceYes
2018-10-01Plan benefit arrangement – InsuranceYes
2017: ARUNDEL LODGE, INC. LIFE AND ADD PLAN 2017 form 5500 responses
2017-10-01Type of plan entitySingle employer plan
2017-10-01Plan funding arrangement – InsuranceYes
2017-10-01Plan benefit arrangement – InsuranceYes
2016: ARUNDEL LODGE, INC. LIFE AND ADD PLAN 2016 form 5500 responses
2016-10-01Type of plan entitySingle employer plan
2016-10-01Submission has been amendedNo
2016-10-01This submission is the final filingNo
2016-10-01This return/report is a short plan year return/report (less than 12 months)No
2016-10-01Plan is a collectively bargained planNo
2016-10-01Plan funding arrangement – InsuranceYes
2016-10-01Plan benefit arrangement – InsuranceYes
2015: ARUNDEL LODGE, INC. LIFE AND ADD PLAN 2015 form 5500 responses
2015-10-01Type of plan entitySingle employer plan
2015-10-01First time form 5500 has been submittedYes
2015-10-01Submission has been amendedNo
2015-10-01This submission is the final filingNo
2015-10-01This return/report is a short plan year return/report (less than 12 months)No
2015-10-01Plan is a collectively bargained planNo
2015-10-01Plan funding arrangement – InsuranceYes
2015-10-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGLUG0BS42
Policy instance 2
Insurance contract or identification numberGLUG0BS42
Number of Individuals Covered113
Insurance policy start date2022-10-01
Insurance policy end date2023-09-30
Total amount of commissions paid to insurance brokerUSD $3,395
Total amount of fees paid to insurance companyUSD $1,976
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT, EMPLOYEE ASSISTANCE PROGRAM
Welfare Benefit Premiums Paid to CarrierUSD $22,634
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,395
Amount paid for insurance broker fees0
Insurance broker organization code?3
Additional information about fees paid to insurance brokerADMINISTRATION
CAREFIRST BLUECHOICE (National Association of Insurance Commissioners NAIC id number: 96202 )
Policy contract number25V8
Policy instance 1
Insurance contract or identification number25V8
Number of Individuals Covered108
Insurance policy start date2022-10-01
Insurance policy end date2023-09-30
Total amount of commissions paid to insurance brokerUSD $2,566
Total amount of fees paid to insurance companyUSD $55,263
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $606,770
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,566
Amount paid for insurance broker fees41908
Additional information about fees paid to insurance brokerPERSISTENCY BONUS, PRODUCER SERVICE FEE
Insurance broker organization code?3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGLUG0BS42
Policy instance 2
Insurance contract or identification numberGLUG0BS42
Number of Individuals Covered104
Insurance policy start date2021-10-01
Insurance policy end date2022-09-30
Total amount of commissions paid to insurance brokerUSD $2,792
Total amount of fees paid to insurance companyUSD $2,318
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT, EMPLOYEE ASSISTANCE PROGRAM
Welfare Benefit Premiums Paid to CarrierUSD $20,773
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,792
Amount paid for insurance broker fees0
Insurance broker organization code?3
Additional information about fees paid to insurance brokerOTHER COMPENSATION
CAREFIRST BLUECHOICE (National Association of Insurance Commissioners NAIC id number: 96202 )
Policy contract number25V8
Policy instance 1
Insurance contract or identification number25V8
Number of Individuals Covered122
Insurance policy start date2021-10-01
Insurance policy end date2022-09-30
Total amount of commissions paid to insurance brokerUSD $2,334
Total amount of fees paid to insurance companyUSD $51,569
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $599,275
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,334
Amount paid for insurance broker fees37433
Additional information about fees paid to insurance brokerPERSISTENCY BONUS, PRODUCER SERVICE FEE
Insurance broker organization code?3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGLUG0BS42
Policy instance 2
Insurance contract or identification numberGLUG0BS42
Number of Individuals Covered113
Insurance policy start date2020-10-01
Insurance policy end date2021-09-30
Total amount of commissions paid to insurance brokerUSD $2,691
Total amount of fees paid to insurance companyUSD $1,437
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $21,820
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,691
Amount paid for insurance broker fees0
Insurance broker organization code?3
Additional information about fees paid to insurance brokerADMINISTRATION
CAREFIRST BLUECHOICE (National Association of Insurance Commissioners NAIC id number: 96202 )
Policy contract number25V8
Policy instance 1
Insurance contract or identification number25V8
Number of Individuals Covered130
Insurance policy start date2020-10-01
Insurance policy end date2021-09-30
Total amount of commissions paid to insurance brokerUSD $2,739
Total amount of fees paid to insurance companyUSD $45,549
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $646,947
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,739
Amount paid for insurance broker fees29641
Additional information about fees paid to insurance brokerPRODUCER SERVICE FEE
Insurance broker organization code?3
CAREFIRST BLUECHOICE (National Association of Insurance Commissioners NAIC id number: 96202 )
Policy contract number25V8
Policy instance 2
Insurance contract or identification number25V8
Number of Individuals Covered145
Insurance policy start date2019-10-01
Insurance policy end date2020-09-30
Total amount of commissions paid to insurance brokerUSD $2,662
Total amount of fees paid to insurance companyUSD $41,612
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $629,689
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,662
Amount paid for insurance broker fees27455
Additional information about fees paid to insurance brokerPRODUCER SERVICE FEE
Insurance broker organization code?3
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number5318743
Policy instance 1
Insurance contract or identification number5318743
Number of Individuals Covered129
Insurance policy start date2019-10-01
Insurance policy end date2020-09-30
Total amount of commissions paid to insurance brokerUSD $3,336
Total amount of fees paid to insurance companyUSD $1,261
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $16,658
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,336
Amount paid for insurance broker fees824
Additional information about fees paid to insurance brokerADMINISTRATION FEES
Insurance broker organization code?5
CAREFIRST BLUECHOICE (National Association of Insurance Commissioners NAIC id number: 96202 )
Policy contract number25V8
Policy instance 2
Insurance contract or identification number25V8
Number of Individuals Covered134
Insurance policy start date2018-10-01
Insurance policy end date2019-09-30
Total amount of commissions paid to insurance brokerUSD $23,412
Total amount of fees paid to insurance companyUSD $39,113
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $609,141
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $23,412
Amount paid for insurance broker fees27132
Additional information about fees paid to insurance brokerNEW BUSINESS BONUS NON-MONETARY COMPENSATION MEDICAL/DENTAL/VISION CONTRACTS X PCPM
Insurance broker organization code?3
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number5318743
Policy instance 1
Insurance contract or identification number5318743
Number of Individuals Covered118
Insurance policy start date2018-10-01
Insurance policy end date2019-09-30
Total amount of commissions paid to insurance brokerUSD $2,925
Total amount of fees paid to insurance companyUSD $434
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $14,605
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,925
Amount paid for insurance broker fees0
Insurance broker organization code?3
Additional information about fees paid to insurance brokerSUPPLEMENTAL COMPENSATION
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract numberTS05318743
Policy instance 1
Insurance contract or identification numberTS05318743
Number of Individuals Covered119
Insurance policy start date2017-10-01
Insurance policy end date2018-09-30
Total amount of commissions paid to insurance brokerUSD $2,276
Total amount of fees paid to insurance companyUSD $1,198
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $15,252
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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