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| Plan Name | SUMMIT CARE II, INC. WELFARE BENEFIT PLAN |
| Plan identification number | 504 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
|
| Company Name: | SUMMIT CARE II,INC. |
| Employer identification number (EIN): | 593734290 |
| 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 |
|---|---|---|---|---|---|
| 504 | 2023-10-01 | JOSEPH MITCHELL | |||
| 504 | 2022-10-01 | ||||
| 504 | 2022-10-01 | JOSEPH MITCHELL | |||
| 504 | 2021-10-01 | ||||
| 504 | 2021-10-01 | JOSEPH MITCHELL | |||
| 504 | 2020-10-01 | ||||
| 504 | 2019-10-01 | ||||
| 504 | 2018-10-01 | ||||
| 504 | 2017-10-01 | ||||
| 504 | 2016-10-01 | JOSEPH MITCHELL | JOSEPH MITCHELL | 2018-03-21 |
| Measure | Date | Value |
|---|---|---|
| 2022: SUMMIT CARE II, INC. WELFARE BENEFIT PLAN 2022 401k membership | ||
| Total participants, beginning-of-year | 2022-10-01 | 1,481 |
| Total number of active participants reported on line 7a of the Form 5500 | 2022-10-01 | 1,490 |
| Total of all active and inactive participants | 2022-10-01 | 1,490 |
| Total participants | 2022-10-01 | 1,490 |
| 2021: SUMMIT CARE II, INC. WELFARE BENEFIT PLAN 2021 401k membership | ||
| Total participants, beginning-of-year | 2021-10-01 | 1,485 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-10-01 | 1,481 |
| Total of all active and inactive participants | 2021-10-01 | 1,481 |
| Total participants | 2021-10-01 | 1,481 |
| 2020: SUMMIT CARE II, INC. WELFARE BENEFIT PLAN 2020 401k membership | ||
| Total participants, beginning-of-year | 2020-10-01 | 717 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-10-01 | 1,485 |
| Total of all active and inactive participants | 2020-10-01 | 1,485 |
| Total participants | 2020-10-01 | 1,485 |
| 2019: SUMMIT CARE II, INC. WELFARE BENEFIT PLAN 2019 401k membership | ||
| Total participants, beginning-of-year | 2019-10-01 | 1,225 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-10-01 | 717 |
| Total of all active and inactive participants | 2019-10-01 | 717 |
| Total participants | 2019-10-01 | 717 |
| 2018: SUMMIT CARE II, INC. WELFARE BENEFIT PLAN 2018 401k membership | ||
| Total participants, beginning-of-year | 2018-10-01 | 1,123 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-10-01 | 1,225 |
| Total of all active and inactive participants | 2018-10-01 | 1,225 |
| Total participants | 2018-10-01 | 1,225 |
| 2017: SUMMIT CARE II, INC. WELFARE BENEFIT PLAN 2017 401k membership | ||
| Total participants, beginning-of-year | 2017-10-01 | 1,511 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-10-01 | 1,123 |
| Total of all active and inactive participants | 2017-10-01 | 1,123 |
| Total participants | 2017-10-01 | 1,123 |
| 2016: SUMMIT CARE II, INC. WELFARE BENEFIT PLAN 2016 401k membership | ||
| Total participants, beginning-of-year | 2016-10-01 | 1,391 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-10-01 | 1,511 |
| Total of all active and inactive participants | 2016-10-01 | 1,511 |
| Total participants | 2016-10-01 | 1,511 |
| 2022: SUMMIT CARE II, INC. WELFARE BENEFIT PLAN 2022 form 5500 responses | ||
|---|---|---|
| 2022-10-01 | Type of plan entity | Single employer plan |
| 2022-10-01 | Submission has been amended | No |
| 2022-10-01 | This submission is the final filing | No |
| 2022-10-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2022-10-01 | Plan is a collectively bargained plan | No |
| 2022-10-01 | Plan funding arrangement – Insurance | Yes |
| 2022-10-01 | Plan benefit arrangement – Insurance | Yes |
| 2021: SUMMIT CARE II, INC. WELFARE BENEFIT PLAN 2021 form 5500 responses | ||
| 2021-10-01 | Type of plan entity | Single employer plan |
| 2021-10-01 | Submission has been amended | No |
| 2021-10-01 | This submission is the final filing | No |
| 2021-10-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2021-10-01 | Plan is a collectively bargained plan | No |
| 2021-10-01 | Plan funding arrangement – Insurance | Yes |
| 2021-10-01 | Plan benefit arrangement – Insurance | Yes |
| 2020: SUMMIT CARE II, INC. WELFARE BENEFIT PLAN 2020 form 5500 responses | ||
| 2020-10-01 | Type of plan entity | Single employer plan |
| 2020-10-01 | Submission has been amended | No |
| 2020-10-01 | This submission is the final filing | No |
| 2020-10-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2020-10-01 | Plan is a collectively bargained plan | No |
| 2020-10-01 | Plan funding arrangement – Insurance | Yes |
| 2020-10-01 | Plan benefit arrangement – Insurance | Yes |
| 2019: SUMMIT CARE II, INC. WELFARE BENEFIT PLAN 2019 form 5500 responses | ||
| 2019-10-01 | Type of plan entity | Single employer plan |
| 2019-10-01 | Submission has been amended | No |
| 2019-10-01 | This submission is the final filing | No |
| 2019-10-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2019-10-01 | Plan is a collectively bargained plan | No |
| 2019-10-01 | Plan funding arrangement – Insurance | Yes |
| 2019-10-01 | Plan benefit arrangement – Insurance | Yes |
| 2018: SUMMIT CARE II, INC. WELFARE BENEFIT PLAN 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 | No |
| 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: SUMMIT CARE II, INC. WELFARE BENEFIT PLAN 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: SUMMIT CARE II, INC. WELFARE BENEFIT PLAN 2016 form 5500 responses | ||
| 2016-10-01 | Type of plan entity | Single employer plan |
| 2016-10-01 | First time form 5500 has been submitted | Yes |
| 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 |
| USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 ) | |
| Policy contract number | 50035887 |
| Policy instance | 7 |
| BLUE CROSS BLUE SHIELD OF FLORIDA (National Association of Insurance Commissioners NAIC id number: 98167 ) | |
| Policy contract number | 98167 |
| Policy instance | 1 |
| PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68195 ) | |
| Policy contract number | 0010675484 |
| Policy instance | 2 |
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) | |
| Policy contract number | R0597153 |
| Policy instance | 3 |
| FLORIDA COMBINED LIFE INSURANCE COMPANY, INC. (National Association of Insurance Commissioners NAIC id number: 76031 ) | |
| Policy contract number | Y1147-Y55B58 |
| Policy instance | 4 |
| CAPITAL HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 95112 ) | |
| Policy contract number | 00452 |
| Policy instance | 5 |
| BLUE CROSS BLUE SHIELD OF FLORIDA (National Association of Insurance Commissioners NAIC id number: 98167 ) | |
| Policy contract number | 64648 |
| Policy instance | 6 |
| BLUE CROSS BLUE SHIELD OF FLORIDA (National Association of Insurance Commissioners NAIC id number: 98167 ) | |
| Policy contract number | 64648 |
| Policy instance | 1 |
| PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68195 ) | |
| Policy contract number | 0010675484 |
| Policy instance | 2 |
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) | |
| Policy contract number | R0597153 |
| Policy instance | 3 |
| FLORIDA COMBINED LIFE INSURANCE COMPANY, INC. (National Association of Insurance Commissioners NAIC id number: 76031 ) | |
| Policy contract number | Y1147-Y55B58 |
| Policy instance | 4 |
| CAPITAL HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 95112 ) | |
| Policy contract number | 00452 |
| Policy instance | 5 |
| BLUE CROSS BLUE SHIELD OF FLORIDA (National Association of Insurance Commissioners NAIC id number: 98167 ) | |
| Policy contract number | 64648 |
| Policy instance | 6 |
| USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 ) | |
| Policy contract number | 50035887 |
| Policy instance | 7 |
| USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 ) | |
| Policy contract number | 50035887 |
| Policy instance | 7 |
| BLUE CROSS BLUE SHIELD OF FLORIDA (National Association of Insurance Commissioners NAIC id number: 98167 ) | |
| Policy contract number | 64648 |
| Policy instance | 6 |
| CAPITAL HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 95112 ) | |
| Policy contract number | 00452 |
| Policy instance | 5 |
| FLORIDA COMBINED LIFE (National Association of Insurance Commissioners NAIC id number: 20603 ) | |
| Policy contract number | Y1147-Y55B58 |
| Policy instance | 4 |
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) | |
| Policy contract number | R0597153 |
| Policy instance | 3 |
| PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68195 ) | |
| Policy contract number | 0010675484 |
| Policy instance | 2 |
| BLUE CROSS BLUE SHIELD OF FLORIDA (National Association of Insurance Commissioners NAIC id number: 98167 ) | |
| Policy contract number | 64648 |
| Policy instance | 1 |
| BLUE CROSS BLUE SHIELD OF FLORIDA (National Association of Insurance Commissioners NAIC id number: 98167 ) | |
| Policy contract number | 64648 |
| Policy instance | 1 |
| PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68195 ) | |
| Policy contract number | 0010675484 |
| Policy instance | 2 |
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) | |
| Policy contract number | R0597153 |
| Policy instance | 3 |
| FLORIDA COMBINED LIFE (National Association of Insurance Commissioners NAIC id number: 20603 ) | |
| Policy contract number | Y1147-Y55B58 |
| Policy instance | 4 |
| CAPITAL HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 95112 ) | |
| Policy contract number | 00452 |
| Policy instance | 5 |
| BLUE CROSS BLUE SHIELD OF FLORIDA (National Association of Insurance Commissioners NAIC id number: 98167 ) | |
| Policy contract number | 64648 |
| Policy instance | 6 |
| USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 ) | |
| Policy contract number | 50035887 |
| Policy instance | 7 |
| PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68195 ) | |
| Policy contract number | 0010675484 |
| Policy instance | 2 |
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) | |
| Policy contract number | R0597153 |
| Policy instance | 3 |
| BLUE CROSS BLUE SHIELD OF FLORIDA (National Association of Insurance Commissioners NAIC id number: 98167 ) | |
| Policy contract number | 64648 |
| Policy instance | 4 |
| FLORIDA COMBINED LIFE (National Association of Insurance Commissioners NAIC id number: 20603 ) | |
| Policy contract number | Y1147-Y55B58 |
| Policy instance | 5 |
| FLORIDA COMBINED LIFE INSURANCE COMPANY, INC. (National Association of Insurance Commissioners NAIC id number: 76031 ) | |
| Policy contract number | 64648 |
| Policy instance | 6 |
| CAPITAL HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 95112 ) | |
| Policy contract number | 00452 |
| Policy instance | 7 |
| BLUE CROSS BLUE SHIELD OF FLORIDA (National Association of Insurance Commissioners NAIC id number: 98167 ) | |
| Policy contract number | 64648 |
| Policy instance | 1 |
| PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68195 ) | |
| Policy contract number | 0010675484 |
| Policy instance | 2 |
| BLUE CROSS BLUE SHIELD OF FLORIDA (National Association of Insurance Commissioners NAIC id number: 98167 ) | |
| Policy contract number | 64648 |
| Policy instance | 1 |
| BLUE CROSS BLUE SHIELD OF FLORIDA (National Association of Insurance Commissioners NAIC id number: 98167 ) | |
| Policy contract number | 64648 |
| Policy instance | 4 |
| FLORIDA COMBINED LIFE (National Association of Insurance Commissioners NAIC id number: 20603 ) | |
| Policy contract number | Y1147-Y55B58 |
| Policy instance | 5 |
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) | |
| Policy contract number | R0597153 |
| Policy instance | 3 |