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SUPPL LIFE 401k Plan overview

Plan NameSUPPL LIFE
Plan identification number 513

SUPPL LIFE Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Life insurance
  • 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 SUPPL LIFE

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5132012-01-01DALE KNEE
5132011-01-01DALE KNEE
5132010-01-01DALE KNEE

Plan Statistics for SUPPL LIFE

401k plan membership statisitcs for SUPPL LIFE

Measure Date Value
2012: SUPPL LIFE 2012 401k membership
Total participants, beginning-of-year2012-01-010
Total number of active participants reported on line 7a of the Form 55002012-01-010
Total of all active and inactive participants2012-01-010
Total participants2012-01-010
2011: SUPPL LIFE 2011 401k membership
Total participants, beginning-of-year2011-01-01755
Total number of active participants reported on line 7a of the Form 55002011-01-01744
Total of all active and inactive participants2011-01-01744
Total participants2011-01-01744
2010: SUPPL LIFE 2010 401k membership
Total participants, beginning-of-year2010-01-010
Total number of active participants reported on line 7a of the Form 55002010-01-01755
Total of all active and inactive participants2010-01-01755
Total participants2010-01-01755

Form 5500 Responses for SUPPL LIFE

2012: SUPPL LIFE 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 filingYes
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: SUPPL LIFE 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: SUPPL LIFE 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01First time form 5500 has been submittedYes
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

Insurance Providers Used on plan

FLORIDA COMBINED LIFE INSURANCE COMPANY, INC. (National Association of Insurance Commissioners NAIC id number: 76031 )
Policy contract number75586
Policy instance 1
Insurance contract or identification number75586
Number of Individuals Covered744
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of fees paid to insurance companyUSD $18,625
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $150,474
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
FLORIDA COMBINED LIFE INSURANCE COMPANY, INC. (National Association of Insurance Commissioners NAIC id number: 76031 )
Policy contract number45586
Policy instance 1
Insurance contract or identification number45586
Number of Individuals Covered755
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of fees paid to insurance companyUSD $19,266
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $152,963
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees19266
Insurance broker nameRODNEY RICH & COMPANY

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