CHARTER SENIOR LIVING, LLC HEALTH AND WELFARE PLAN 401k Plan overview
| Plan Name | CHARTER SENIOR LIVING, LLC HEALTH AND WELFARE PLAN |
| Plan identification number | 502 |
CHARTER SENIOR LIVING, LLC HEALTH AND WELFARE PLAN Benefits
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits | - Health (other than dental or vision)
- Life insurance
- Dental
- Vision
- Death benefits (include travel accident but not life insurance)
|
401k Sponsoring company profile
CHARTER SENIOR LIVING, LLC has sponsored the creation of one or more 401k plans.
Additional information about CHARTER SENIOR LIVING, LLC
| Jurisdiction of Incorporation: | State of Delaware Division of Corporations |
| Incorporation Date: | |
| Company Identification Number: | 5984804 |
More information about CHARTER SENIOR LIVING, LLC
Form 5500 Filing Information
Submission information for form 5500 for 401k plan CHARTER SENIOR LIVING, LLC HEALTH AND WELFARE PLAN
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|
| 502 | 2020-01-01 | KEVIN J. BENNEMA | 2022-07-01 | | |
| 502 | 2019-01-01 | KEVIN J. BENNEMA | 2022-07-01 | | |
Plan Statistics for CHARTER SENIOR LIVING, LLC HEALTH AND WELFARE PLAN
401k plan membership statisitcs for CHARTER SENIOR LIVING, LLC HEALTH AND WELFARE PLAN
| Measure | Date | Value |
|---|
| 2020: CHARTER SENIOR LIVING, LLC HEALTH AND WELFARE PLAN 2020 401k membership |
|---|
| Total participants, beginning-of-year | 2020-01-01 | 209 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-01-01 | 205 |
| Number of retired or separated participants receiving benefits | 2020-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2020-01-01 | 0 |
| Total of all active and inactive participants | 2020-01-01 | 205 |
| Number of employers contributing to the scheme | 2020-01-01 | 0 |
| 2019: CHARTER SENIOR LIVING, LLC HEALTH AND WELFARE PLAN 2019 401k membership |
|---|
| Total participants, beginning-of-year | 2019-01-01 | 100 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-01-01 | 209 |
| Number of retired or separated participants receiving benefits | 2019-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2019-01-01 | 0 |
| Total of all active and inactive participants | 2019-01-01 | 209 |
| Number of employers contributing to the scheme | 2019-01-01 | 0 |
Form 5500 Responses for CHARTER SENIOR LIVING, LLC HEALTH AND WELFARE PLAN
| 2020: CHARTER SENIOR LIVING, LLC HEALTH AND WELFARE PLAN 2020 form 5500 responses |
|---|
| 2020-01-01 | Type of plan entity | Single employer plan |
| 2020-01-01 | Plan funding arrangement – Insurance | Yes |
| 2020-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2019: CHARTER SENIOR LIVING, LLC HEALTH AND WELFARE PLAN 2019 form 5500 responses |
|---|
| 2019-01-01 | Type of plan entity | Single employer plan |
| 2019-01-01 | First time form 5500 has been submitted | Yes |
| 2019-01-01 | Plan funding arrangement – Insurance | Yes |
| 2019-01-01 | Plan benefit arrangement – Insurance | Yes |
Insurance Providers Used on plan
| AXIS INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 37273 ) |
| Policy contract number | 8424183 |
| Policy instance | 1 |
| Insurance contract or identification number | 8424183 | | Number of Individuals Covered | 205 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $18,945 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $189,119 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $18,945 | | Amount paid for insurance broker fees | 0 | | Insurance broker organization code? | 3 |
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