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COVENANT HOSPICE, INC. 401k Plan overview

Plan NameCOVENANT HOSPICE, INC.
Plan identification number 505

COVENANT HOSPICE, INC. Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Temporary disability (accident and sickness)

401k Sponsoring company profile

COVENANT HOSPICE, INC. has sponsored the creation of one or more 401k plans.

Company Name:COVENANT HOSPICE, INC.
Employer identification number (EIN):592208300
NAIC Classification:621610
NAIC Description:Home Health Care Services

Additional information about COVENANT HOSPICE, INC.

Jurisdiction of Incorporation: Florida Department of State Division of Corporations
Incorporation Date: 1981-08-04
Company Identification Number: 759452
Legal Registered Office Address: 501 COMMENDENCIA ST

PENSACOLA

32502

More information about COVENANT HOSPICE, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan COVENANT HOSPICE, INC.

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5052014-01-01AMY BAJJALY
5052013-01-01ODIN BERG ODIN BERG2014-07-17
5052012-01-01DALE KNEE
5052011-01-01DALE KNEE
5052010-01-01DALE KNEE
5052009-01-01DALE KNEE

Plan Statistics for COVENANT HOSPICE, INC.

401k plan membership statisitcs for COVENANT HOSPICE, INC.

Measure Date Value
2014: COVENANT HOSPICE, INC. 2014 401k membership
Total participants, beginning-of-year2014-01-01160
Total number of active participants reported on line 7a of the Form 55002014-01-010
Number of retired or separated participants receiving benefits2014-01-010
Number of other retired or separated participants entitled to future benefits2014-01-010
Total of all active and inactive participants2014-01-010
2013: COVENANT HOSPICE, INC. 2013 401k membership
Total participants, beginning-of-year2013-01-01211
Total number of active participants reported on line 7a of the Form 55002013-01-01215
Total of all active and inactive participants2013-01-01215
Total participants2013-01-01215
2012: COVENANT HOSPICE, INC. 2012 401k membership
Total participants, beginning-of-year2012-01-01212
Total number of active participants reported on line 7a of the Form 55002012-01-01211
Total of all active and inactive participants2012-01-01211
Total participants2012-01-01211
2011: COVENANT HOSPICE, INC. 2011 401k membership
Total participants, beginning-of-year2011-01-01176
Total number of active participants reported on line 7a of the Form 55002011-01-01212
Total of all active and inactive participants2011-01-01212
Total participants2011-01-01212
2010: COVENANT HOSPICE, INC. 2010 401k membership
Total participants, beginning-of-year2010-01-01182
Total number of active participants reported on line 7a of the Form 55002010-01-01176
Total of all active and inactive participants2010-01-01176
Total participants2010-01-01176
2009: COVENANT HOSPICE, INC. 2009 401k membership
Total participants, beginning-of-year2009-01-01150
Total number of active participants reported on line 7a of the Form 55002009-01-01184
Number of retired or separated participants receiving benefits2009-01-010
Number of other retired or separated participants entitled to future benefits2009-01-010
Total of all active and inactive participants2009-01-01184
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2009-01-010
Total participants2009-01-01184

Form 5500 Responses for COVENANT HOSPICE, INC.

2014: COVENANT HOSPICE, INC. 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Submission has been amendedNo
2014-01-01This submission is the final filingYes
2014-01-01This return/report is a short plan year return/report (less than 12 months)No
2014-01-01Plan is a collectively bargained planNo
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan benefit arrangement – InsuranceYes
2013: COVENANT HOSPICE, INC. 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Submission has been amendedNo
2013-01-01This submission is the final filingNo
2013-01-01This return/report is a short plan year return/report (less than 12 months)No
2013-01-01Plan is a collectively bargained planNo
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan benefit arrangement – InsuranceYes
2012: COVENANT HOSPICE, INC. 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Submission has been amendedNo
2012-01-01This submission is the final filingNo
2012-01-01This return/report is a short plan year return/report (less than 12 months)No
2012-01-01Plan is a collectively bargained planNo
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan benefit arrangement – InsuranceYes
2011: COVENANT HOSPICE, INC. 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Submission has been amendedNo
2011-01-01This submission is the final filingNo
2011-01-01This return/report is a short plan year return/report (less than 12 months)No
2011-01-01Plan is a collectively bargained planNo
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan benefit arrangement – InsuranceYes
2010: COVENANT HOSPICE, INC. 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01Submission has been amendedNo
2010-01-01This submission is the final filingNo
2010-01-01This return/report is a short plan year return/report (less than 12 months)No
2010-01-01Plan is a collectively bargained planNo
2010-01-01Plan funding arrangement – InsuranceYes
2010-01-01Plan benefit arrangement – InsuranceYes
2009: COVENANT HOSPICE, INC. 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Submission has been amendedNo
2009-01-01This submission is the final filingNo
2009-01-01This return/report is a short plan year return/report (less than 12 months)No
2009-01-01Plan is a collectively bargained planNo
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 )
Policy contract numberE7317910
Policy instance 1
Insurance contract or identification numberE7317910
Number of Individuals Covered160
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $11,975
Total amount of fees paid to insurance companyUSD $1,560
Are there contracts with allocated funds for individual policies?No
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
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $113,748
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,839
Insurance broker organization code?3
Amount paid for insurance broker fees798
Additional information about fees paid to insurance brokerFEES
Insurance broker nameJENNIFER WEYMOUTH EVANS
COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 )
Policy contract numberE7317910
Policy instance 1
Insurance contract or identification numberE7317910
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $20,210
Total amount of fees paid to insurance companyUSD $1,295
Are there contracts with allocated funds for individual policies?No
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
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedCANCER
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $143,140
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9
Amount paid for insurance broker fees3
Insurance broker nameWILLIAM C. WESTER
COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 )
Policy contract numberE7317910
Policy instance 1
Insurance contract or identification numberE7317910
Number of Individuals Covered211
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $24,644
Total amount of fees paid to insurance companyUSD $1,891
Temporary Disability Insurance Welfare BenefitYes
Other welfare benefits providedCANCER
Welfare Benefit Premiums Paid to CarrierUSD $148,319
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9,399
Amount paid for insurance broker fees512
Insurance broker nameLYNN SPOTTS CARMICHAEL
COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 )
Policy contract numberE7317910
Policy instance 1
Insurance contract or identification numberE7317910
Number of Individuals Covered212
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $21,415
Total amount of fees paid to insurance companyUSD $2,175
Temporary Disability Insurance Welfare BenefitYes
Other welfare benefits providedCANCER
Welfare Benefit Premiums Paid to CarrierUSD $125,857
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 )
Policy contract numberE7317910
Policy instance 1
Insurance contract or identification numberE7317910
Number of Individuals Covered176
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $12,869
Total amount of fees paid to insurance companyUSD $1,785
Temporary Disability Insurance Welfare BenefitYes
Other welfare benefits providedCANCER
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,011
Amount paid for insurance broker fees78
Insurance broker nameELANA D'ARCIPRETE

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