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| Plan Name | BRANDYWYNE CONVALESCENT CENTER |
| Plan identification number | 501 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
|
| Company Name: | BRANDYWINE CONVALESCENT CENTER I |
| Employer identification number (EIN): | 593635204 |
| 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 |
|---|---|---|---|---|---|
| 501 | 2018-10-01 | ||||
| 501 | 2017-10-01 | ||||
| 501 | 2016-10-01 | LYNN SHARPLESS | 2020-03-17 | ||
| 501 | 2015-10-01 | ||||
| 501 | 2014-10-01 |
| 2018: BRANDYWYNE CONVALESCENT CENTER 2018 form 5500 responses | ||
|---|---|---|
| 2018-10-01 | Type of plan entity | Single employer plan |
| 2018-10-01 | Submission has been amended | No |
| 2018-10-01 | This submission is the final filing | Yes |
| 2018-10-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2018-10-01 | Plan is a collectively bargained plan | No |
| 2018-10-01 | Plan funding arrangement – Insurance | Yes |
| 2018-10-01 | Plan benefit arrangement – Insurance | Yes |
| 2017: BRANDYWYNE CONVALESCENT CENTER 2017 form 5500 responses | ||
| 2017-10-01 | Type of plan entity | Single employer plan |
| 2017-10-01 | Submission has been amended | No |
| 2017-10-01 | This submission is the final filing | No |
| 2017-10-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2017-10-01 | Plan is a collectively bargained plan | No |
| 2017-10-01 | Plan funding arrangement – Insurance | Yes |
| 2017-10-01 | Plan benefit arrangement – Insurance | Yes |
| 2016: BRANDYWYNE CONVALESCENT CENTER 2016 form 5500 responses | ||
| 2016-10-01 | Type of plan entity | Single employer plan |
| 2016-10-01 | Submission has been amended | No |
| 2016-10-01 | This submission is the final filing | No |
| 2016-10-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2016-10-01 | Plan is a collectively bargained plan | No |
| 2016-10-01 | Plan funding arrangement – Insurance | Yes |
| 2016-10-01 | Plan benefit arrangement – Insurance | Yes |
| 2015: BRANDYWYNE CONVALESCENT CENTER 2015 form 5500 responses | ||
| 2015-10-01 | Type of plan entity | Single employer plan |
| 2015-10-01 | Submission has been amended | No |
| 2015-10-01 | This submission is the final filing | No |
| 2015-10-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2015-10-01 | Plan is a collectively bargained plan | No |
| 2015-10-01 | Plan funding arrangement – Insurance | Yes |
| 2015-10-01 | Plan benefit arrangement – Insurance | Yes |
| 2014: BRANDYWYNE CONVALESCENT CENTER 2014 form 5500 responses | ||
| 2014-10-01 | Type of plan entity | Single employer plan |
| 2014-10-01 | First time form 5500 has been submitted | Yes |
| 2014-10-01 | Submission has been amended | No |
| 2014-10-01 | This submission is the final filing | No |
| 2014-10-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2014-10-01 | Plan is a collectively bargained plan | No |
| 2014-10-01 | Plan funding arrangement – Insurance | Yes |
| 2014-10-01 | Plan benefit arrangement – Insurance | Yes |
| BLUE CROSS BLUE SHIELD OF FLORIDA (National Association of Insurance Commissioners NAIC id number: 95089 ) | |
| Policy contract number | 60512 |
| Policy instance | 1 |
| BLUE CROSS BLUE SHIELD OF FLORIDA (National Association of Insurance Commissioners NAIC id number: 98167 ) | |
| Policy contract number | 60512 |
| Policy instance | 2 |
| SAFEGUARD HEALTH PLANS, INC., A FLORIDA CORPORATION (National Association of Insurance Commissioners NAIC id number: 52009 ) | |
| Policy contract number | 5939999 |
| Policy instance | 3 |
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) | |
| Policy contract number | 5939999 |
| Policy instance | 4 |
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) | |
| Policy contract number | TM05939999 |
| Policy instance | 4 |
| BLUE CROSS BLUE SHIELD OF FLORIDA (National Association of Insurance Commissioners NAIC id number: 98167 ) | |
| Policy contract number | 60512 |
| Policy instance | 2 |
| BLUE CROSS BLUE SHIELD OF FLORIDA (National Association of Insurance Commissioners NAIC id number: 95089 ) | |
| Policy contract number | 60512 |
| Policy instance | 1 |
| SAFEGUARD HEALTH PLANS, INC., A FLORIDA CORPORATION (National Association of Insurance Commissioners NAIC id number: 52009 ) | |
| Policy contract number | TM05939999 |
| Policy instance | 3 |
| FLORIDA COMBINED LIFE INSURANCE COMPANY, INC. (National Association of Insurance Commissioners NAIC id number: 76031 ) | |
| Policy contract number | 29808 |
| Policy instance | 6 |
| FLORIDA COMBINED LIFE (National Association of Insurance Commissioners NAIC id number: 20603 ) | |
| Policy contract number | 29807 |
| Policy instance | 7 |
| FLORIDA COMBINED LIFE (National Association of Insurance Commissioners NAIC id number: 20603 ) | |
| Policy contract number | 29805 |
| Policy instance | 8 |
| FLORIDA COMBINED LIFE (National Association of Insurance Commissioners NAIC id number: 20603 ) | |
| Policy contract number | 29806 |
| Policy instance | 9 |
| FLORIDA COMBINED LIFE (National Association of Insurance Commissioners NAIC id number: 20603 ) | |
| Policy contract number | 29803 |
| Policy instance | 10 |
| FLORIDA COMBINED LIFE INSURANCE COMPANY, INC. (National Association of Insurance Commissioners NAIC id number: 76031 ) | |
| Policy contract number | 29804 |
| Policy instance | 11 |
| FLORIDA COMBINED LIFE (National Association of Insurance Commissioners NAIC id number: 20603 ) | |
| Policy contract number | Y1051-BA8164 |
| Policy instance | 5 |
| FLORIDA COMBINED LIFE (National Association of Insurance Commissioners NAIC id number: 20603 ) | |
| Policy contract number | 60512 |
| Policy instance | 4 |
| BLUE CROSS BLUE SHIELD OF FLORIDA (National Association of Insurance Commissioners NAIC id number: 98167 ) | |
| Policy contract number | 60512 |
| Policy instance | 3 |
| BLUE CROSS BLUE SHIELD OF FLORIDA (National Association of Insurance Commissioners NAIC id number: 95089 ) | |
| Policy contract number | 60512 |
| Policy instance | 2 |
| BLUE CROSS BLUE SHIELD OF FLORIDA (National Association of Insurance Commissioners NAIC id number: 98167 ) | |
| Policy contract number | 60512 |
| Policy instance | 1 |
| BLUE CROSS BLUE SHIELD OF FLORIDA (National Association of Insurance Commissioners NAIC id number: 95089 ) | |
| Policy contract number | 60512 |
| Policy instance | 2 |
| BLUE CROSS BLUE SHIELD OF FLORIDA (National Association of Insurance Commissioners NAIC id number: 98167 ) | |
| Policy contract number | 60512 |
| Policy instance | 3 |
| FLORIDA COMBINED LIFE (National Association of Insurance Commissioners NAIC id number: 20603 ) | |
| Policy contract number | 60512 |
| Policy instance | 4 |
| FLORIDA COMBINED LIFE (National Association of Insurance Commissioners NAIC id number: 20603 ) | |
| Policy contract number | Y1051-BA8164 |
| Policy instance | 5 |
| FLORIDA COMBINED LIFE INSURANCE COMPANY, INC. (National Association of Insurance Commissioners NAIC id number: 76031 ) | |
| Policy contract number | 29808 |
| Policy instance | 6 |
| FLORIDA COMBINED LIFE (National Association of Insurance Commissioners NAIC id number: 20603 ) | |
| Policy contract number | 29807 |
| Policy instance | 7 |
| FLORIDA COMBINED LIFE INSURANCE COMPANY, INC. (National Association of Insurance Commissioners NAIC id number: 76031 ) | |
| Policy contract number | 29809 |
| Policy instance | 8 |
| FLORIDA COMBINED LIFE (National Association of Insurance Commissioners NAIC id number: 20603 ) | |
| Policy contract number | 29805 |
| Policy instance | 9 |
| FLORIDA COMBINED LIFE (National Association of Insurance Commissioners NAIC id number: 20603 ) | |
| Policy contract number | 29806 |
| Policy instance | 10 |
| FLORIDA COMBINED LIFE (National Association of Insurance Commissioners NAIC id number: 20603 ) | |
| Policy contract number | 29803 |
| Policy instance | 11 |
| FLORIDA COMBINED LIFE INSURANCE COMPANY, INC. (National Association of Insurance Commissioners NAIC id number: 76031 ) | |
| Policy contract number | 29804 |
| Policy instance | 12 |
| BLUE CROSS BLUE SHIELD OF FLORIDA (National Association of Insurance Commissioners NAIC id number: 98167 ) | |
| Policy contract number | 60512 |
| Policy instance | 1 |
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