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ARBOR HOUSE LIVING CENTER LLC 401k Plan overview

Plan NameARBOR HOUSE LIVING CENTER LLC
Plan identification number 501

ARBOR HOUSE LIVING CENTER LLC Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Vision

401k Sponsoring company profile

ARBOR HOUSE LIVING CENTER, LLC has sponsored the creation of one or more 401k plans.

Company Name:ARBOR HOUSE LIVING CENTER, LLC
Employer identification number (EIN):731533161
NAIC Classification:623000
NAIC Description: Nursing and Residential Care Facilities

Form 5500 Filing Information

Submission information for form 5500 for 401k plan ARBOR HOUSE LIVING CENTER LLC

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012023-01-01SCOTT H. RICHISON2024-07-18
5012022-01-01SCOTT H. RICHISON2023-10-11
5012021-01-01SCOTT H. RICHISON2022-10-25
5012020-01-01
5012019-01-01
5012018-01-01

Plan Statistics for ARBOR HOUSE LIVING CENTER LLC

401k plan membership statisitcs for ARBOR HOUSE LIVING CENTER LLC

Measure Date Value
2020: ARBOR HOUSE LIVING CENTER LLC 2020 401k membership
Total participants, beginning-of-year2020-01-01112
Total number of active participants reported on line 7a of the Form 55002020-01-01191
Total of all active and inactive participants2020-01-01191
Total participants2020-01-01191
2019: ARBOR HOUSE LIVING CENTER LLC 2019 401k membership
Total participants, beginning-of-year2019-01-01143
Total number of active participants reported on line 7a of the Form 55002019-01-01112
Total of all active and inactive participants2019-01-01112
Total participants2019-01-01112
Number of participants with account balances2019-01-010
2018: ARBOR HOUSE LIVING CENTER LLC 2018 401k membership
Total participants, beginning-of-year2018-01-0190
Total number of active participants reported on line 7a of the Form 55002018-01-01143
Total of all active and inactive participants2018-01-01143
Total participants2018-01-01143

Financial Data on ARBOR HOUSE LIVING CENTER LLC

Measure Date Value
2020 : ARBOR HOUSE LIVING CENTER LLC 2020 401k financial data
Value of total assets at end of year2020-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2020-12-31No
Was this plan covered by a fidelity bond2020-12-31No
If this is an individual account plan, was there a blackout period2020-12-31No
Were there any nonexempt tranactions with any party-in-interest2020-12-31No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2020-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2020-12-31No
Were any leases to which the plan was party in default or uncollectible2020-12-31No
Value of interest in pooled separate accounts at end of year2020-12-31$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2020-12-31No
Was there a failure to transmit to the plan any participant contributions2020-12-31No
Has the plan failed to provide any benefit when due under the plan2020-12-31No
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32020-12-31No
Did the plan have assets held for investment2020-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2020-12-31No
2019 : ARBOR HOUSE LIVING CENTER LLC 2019 401k financial data
Value of total assets at end of year2019-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-12-31No
Was this plan covered by a fidelity bond2019-12-31No
If this is an individual account plan, was there a blackout period2019-12-31No
Were there any nonexempt tranactions with any party-in-interest2019-12-31No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2019-12-31No
Were any leases to which the plan was party in default or uncollectible2019-12-31No
Value of interest in pooled separate accounts at end of year2019-12-31$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-12-31No
Was there a failure to transmit to the plan any participant contributions2019-12-31No
Has the plan failed to provide any benefit when due under the plan2019-12-31No
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32019-12-31No
Did the plan have assets held for investment2019-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-12-31No

Form 5500 Responses for ARBOR HOUSE LIVING CENTER LLC

2020: ARBOR HOUSE LIVING CENTER LLC 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan benefit arrangement – InsuranceYes
2019: ARBOR HOUSE LIVING CENTER LLC 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan benefit arrangement – InsuranceYes
2018: ARBOR HOUSE LIVING CENTER LLC 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01First time form 5500 has been submittedYes
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number1073028
Policy instance 1
Insurance contract or identification number1073028
Number of Individuals Covered191
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $8,843
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,885
Insurance broker organization code?3
AXIS INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 37273 )
Policy contract number8126881
Policy instance 2
Insurance contract or identification number8126881
Number of Individuals Covered73
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $17,538
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $17,538
Insurance broker organization code?3
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number1073028
Policy instance 1
Insurance contract or identification number1073028
Number of Individuals Covered112
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $6,256
Total amount of fees paid to insurance companyUSD $903
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,442
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
Amount paid for insurance broker fees903
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number1073028
Policy instance 1
Insurance contract or identification number1073028
Number of Individuals Covered143
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $8,410
Total amount of fees paid to insurance companyUSD $5,663
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,460
Amount paid for insurance broker fees2931
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3

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