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| Plan Name | HEALTHCARE PLAN OF TRI-DEVELOPMENT CENTER OF AIKEN COUNTY, INC. |
| Plan identification number | 901 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | TRI-DEVELOPMENT CENTER OF AIKEN COUNTY |
| Employer identification number (EIN): | 570669586 |
| NAIC Classification: | 623000 |
| NAIC Description: | Nursing and Residential Care Facilities |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 901 | 2022-09-01 | KAREN PATTEN | 2023-12-01 | ||
| 901 | 2021-09-01 | KAREN PATTEN | 2022-12-13 | ||
| 901 | 2020-09-01 | KAREN PATTEN | 2021-12-17 | ||
| 901 | 2019-09-01 | KAREN PATTEN | 2021-06-10 | ||
| 901 | 2018-09-01 | RALPH COURTNEY | 2020-06-04 | ||
| 901 | 2017-09-01 | KAREN ANDERSON | 2019-04-03 | ||
| 901 | 2016-09-01 | ||||
| 901 | 2015-09-01 | KAREN ANDERSON | |||
| 901 | 2014-09-01 | KAREN ANDERSON | |||
| 901 | 2013-09-01 | KAREN ANDERSON | |||
| 901 | 2012-09-01 | KAREN ANDERSON | KAREN ANDERSON | 2014-05-12 | |
| 901 | 2011-09-01 | KAREN ANDERSON | KAREN ANDERSON | 2013-06-07 | |
| 901 | 2009-09-01 | KAREN ANDERSON | KAREN ANDERSON | 2011-06-09 |
| 2022: HEALTHCARE PLAN OF TRI-DEVELOPMENT CENTER OF AIKEN COUNTY, INC. 2022 form 5500 responses | ||
|---|---|---|
| 2022-09-01 | Type of plan entity | Single employer plan |
| 2022-09-01 | Plan funding arrangement – Insurance | Yes |
| 2022-09-01 | Plan benefit arrangement – Insurance | Yes |
| 2021: HEALTHCARE PLAN OF TRI-DEVELOPMENT CENTER OF AIKEN COUNTY, INC. 2021 form 5500 responses | ||
| 2021-09-01 | Type of plan entity | Single employer plan |
| 2021-09-01 | Plan funding arrangement – Insurance | Yes |
| 2021-09-01 | Plan benefit arrangement – Insurance | Yes |
| 2020: HEALTHCARE PLAN OF TRI-DEVELOPMENT CENTER OF AIKEN COUNTY, INC. 2020 form 5500 responses | ||
| 2020-09-01 | Type of plan entity | Single employer plan |
| 2020-09-01 | Plan funding arrangement – Insurance | Yes |
| 2020-09-01 | Plan benefit arrangement – Insurance | Yes |
| 2019: HEALTHCARE PLAN OF TRI-DEVELOPMENT CENTER OF AIKEN COUNTY, INC. 2019 form 5500 responses | ||
| 2019-09-01 | Type of plan entity | Single employer plan |
| 2019-09-01 | Plan funding arrangement – Insurance | Yes |
| 2019-09-01 | Plan benefit arrangement – Insurance | Yes |
| 2018: HEALTHCARE PLAN OF TRI-DEVELOPMENT CENTER OF AIKEN COUNTY, INC. 2018 form 5500 responses | ||
| 2018-09-01 | Type of plan entity | Single employer plan |
| 2018-09-01 | Plan funding arrangement – Insurance | Yes |
| 2018-09-01 | Plan benefit arrangement – Insurance | Yes |
| 2017: HEALTHCARE PLAN OF TRI-DEVELOPMENT CENTER OF AIKEN COUNTY, INC. 2017 form 5500 responses | ||
| 2017-09-01 | Type of plan entity | Single employer plan |
| 2017-09-01 | Plan funding arrangement – Insurance | Yes |
| 2017-09-01 | Plan benefit arrangement – Insurance | Yes |
| 2016: HEALTHCARE PLAN OF TRI-DEVELOPMENT CENTER OF AIKEN COUNTY, INC. 2016 form 5500 responses | ||
| 2016-09-01 | Type of plan entity | Single employer plan |
| 2016-09-01 | Submission has been amended | No |
| 2016-09-01 | This submission is the final filing | No |
| 2016-09-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2016-09-01 | Plan is a collectively bargained plan | No |
| 2016-09-01 | Plan funding arrangement – Insurance | Yes |
| 2016-09-01 | Plan benefit arrangement – Insurance | Yes |
| 2015: HEALTHCARE PLAN OF TRI-DEVELOPMENT CENTER OF AIKEN COUNTY, INC. 2015 form 5500 responses | ||
| 2015-09-01 | Type of plan entity | Single employer plan |
| 2015-09-01 | Submission has been amended | No |
| 2015-09-01 | This submission is the final filing | No |
| 2015-09-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2015-09-01 | Plan is a collectively bargained plan | No |
| 2015-09-01 | Plan funding arrangement – Insurance | Yes |
| 2015-09-01 | Plan benefit arrangement – Insurance | Yes |
| 2014: HEALTHCARE PLAN OF TRI-DEVELOPMENT CENTER OF AIKEN COUNTY, INC. 2014 form 5500 responses | ||
| 2014-09-01 | Type of plan entity | Single employer plan |
| 2014-09-01 | Submission has been amended | No |
| 2014-09-01 | This submission is the final filing | No |
| 2014-09-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2014-09-01 | Plan is a collectively bargained plan | No |
| 2014-09-01 | Plan funding arrangement – Insurance | Yes |
| 2014-09-01 | Plan benefit arrangement – Insurance | Yes |
| 2013: HEALTHCARE PLAN OF TRI-DEVELOPMENT CENTER OF AIKEN COUNTY, INC. 2013 form 5500 responses | ||
| 2013-09-01 | Type of plan entity | Single employer plan |
| 2013-09-01 | Plan funding arrangement – Insurance | Yes |
| 2013-09-01 | Plan benefit arrangement – Insurance | Yes |
| 2012: HEALTHCARE PLAN OF TRI-DEVELOPMENT CENTER OF AIKEN COUNTY, INC. 2012 form 5500 responses | ||
| 2012-09-01 | Type of plan entity | Single employer plan |
| 2012-09-01 | Plan funding arrangement – Insurance | Yes |
| 2012-09-01 | Plan benefit arrangement – Insurance | Yes |
| 2011: HEALTHCARE PLAN OF TRI-DEVELOPMENT CENTER OF AIKEN COUNTY, INC. 2011 form 5500 responses | ||
| 2011-09-01 | Type of plan entity | Single employer plan |
| 2011-09-01 | Plan funding arrangement – Insurance | Yes |
| 2011-09-01 | Plan benefit arrangement – Insurance | Yes |
| 2009: HEALTHCARE PLAN OF TRI-DEVELOPMENT CENTER OF AIKEN COUNTY, INC. 2009 form 5500 responses | ||
| 2009-09-01 | Type of plan entity | Single employer plan |
| 2009-09-01 | This submission is the final filing | No |
| 2009-09-01 | Plan funding arrangement – Insurance | Yes |
| 2009-09-01 | Plan benefit arrangement – Insurance | Yes |
| BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 38520 ) | |
| Policy contract number | 25-85289 |
| Policy instance | 2 |
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) | |
| Policy contract number | 867913G |
| Policy instance | 1 |
| BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 38520 ) | |
| Policy contract number | 25-85289 |
| Policy instance | 2 |
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) | |
| Policy contract number | 867913G |
| Policy instance | 1 |
| BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 38520 ) | |
| Policy contract number | 25-85289-00 |
| Policy instance | 2 |
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) | |
| Policy contract number | 867913G |
| Policy instance | 1 |
| BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 38520 ) | |
| Policy contract number | 25-85289-00 |
| Policy instance | 2 |
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) | |
| Policy contract number | 867913G |
| Policy instance | 1 |
| BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 38520 ) | |
| Policy contract number | 25-85289-00 |
| Policy instance | 3 |
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) | |
| Policy contract number | 867913G |
| Policy instance | 2 |
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) | |
| Policy contract number | 867913G |
| Policy instance | 1 |
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) | |
| Policy contract number | 867913G |
| Policy instance | 1 |
| BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 38520 ) | |
| Policy contract number | 25-85289-00 |
| Policy instance | 2 |
| BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 38520 ) | |
| Policy contract number | 25-85289-00 |
| Policy instance | 4 |
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) | |
| Policy contract number | 867913G |
| Policy instance | 2 |
| DELTA DENTAL OF MISSOURI (National Association of Insurance Commissioners NAIC id number: 55697 ) | |
| Policy contract number | 62191000 |
| Policy instance | 1 |
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) | |
| Policy contract number | 23838 |
| Policy instance | 3 |
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) | |
| Policy contract number | 867913G |
| Policy instance | 1 |
| UNITED HEALTHCARE (National Association of Insurance Commissioners NAIC id number: 95378 ) | |
| Policy contract number | XW2G |
| Policy instance | 3 |
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) | |
| Policy contract number | 23838 |
| Policy instance | 2 |
| BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 38520 ) | |
| Policy contract number | 25-31638-00 |
| Policy instance | 2 |
| BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 38520 ) | |
| Policy contract number | 25-31638-00 |
| Policy instance | 3 |
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) | |
| Policy contract number | 867913G |
| Policy instance | 1 |
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) | |
| Policy contract number | 867913G |
| Policy instance | 1 |
| BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 38520 ) | |
| Policy contract number | 25-31638-00 |
| Policy instance | 3 |
| BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 38520 ) | |
| Policy contract number | 25-31638-00 |
| Policy instance | 2 |
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) | |
| Policy contract number | 867913G |
| Policy instance | 1 |
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) | |
| Policy contract number | 867913G |
| Policy instance | 1 |
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