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| Plan Name | METHODIST VILLAGE SENIOR LIVING LIFE PLAN |
| Plan identification number | 504 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | METHODIST NURSING HOME OF FORT SMITH INC. |
| Employer identification number (EIN): | 710312652 |
| NAIC Classification: | 812990 |
| NAIC Description: | All Other Personal Services |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 504 | 2019-01-01 | BRYANT DOOLY | 2020-07-28 | ||
| 504 | 2018-01-01 | MELISSA CURRY | 2019-10-08 |
| Measure | Date | Value |
|---|---|---|
| 2019: METHODIST VILLAGE SENIOR LIVING LIFE PLAN 2019 401k membership | ||
| Total participants, beginning-of-year | 2019-01-01 | 159 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-01-01 | 0 |
| Total of all active and inactive participants | 2019-01-01 | 0 |
| 2018: METHODIST VILLAGE SENIOR LIVING LIFE PLAN 2018 401k membership | ||
| Total participants, beginning-of-year | 2018-01-01 | 155 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-01-01 | 159 |
| Total of all active and inactive participants | 2018-01-01 | 159 |
| 2019: METHODIST VILLAGE SENIOR LIVING LIFE PLAN 2019 form 5500 responses | ||
|---|---|---|
| 2019-01-01 | Type of plan entity | Single employer plan |
| 2019-01-01 | This submission is the final filing | Yes |
| 2019-01-01 | Plan funding arrangement – Insurance | Yes |
| 2019-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2019-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2018: METHODIST VILLAGE SENIOR LIVING LIFE PLAN 2018 form 5500 responses | ||
| 2018-01-01 | Type of plan entity | Single employer plan |
| 2018-01-01 | First time form 5500 has been submitted | Yes |
| 2018-01-01 | Plan funding arrangement – Insurance | Yes |
| 2018-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2018-01-01 | Plan benefit arrangement – Insurance | Yes |
| USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 ) | |||||||||||||||||||||||||||
| Policy contract number | 50024476 | ||||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||||
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| USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 ) | |||||||||||||||||||||||||||
| Policy contract number | 50024476 | ||||||||||||||||||||||||||
| Policy instance | 2 | ||||||||||||||||||||||||||
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| USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 ) | |||||||||||||||||||||||||||
| Policy contract number | 50024476 | ||||||||||||||||||||||||||
| Policy instance | 3 | ||||||||||||||||||||||||||
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