401k Plan data: NILE LIVING HEALTH AND WELFARE BENEFITS plan

NILE LIVING HEALTH AND WELFARE BENEFITS 401k Plan overview

Plan Name	NILE LIVING HEALTH AND WELFARE BENEFITS
Plan identification number	501

NILE LIVING HEALTH AND WELFARE BENEFITS 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

NILE LIVING has sponsored the creation of one or more 401k plans.

Company Name: NILE LIVING

Employer identification number (EIN): 824165252

NAIC Classification: 623000
NAIC Description: Nursing and Residential Care Facilities

Form 5500 Filing Information

Submission information for form 5500 for 401k plan NILE LIVING HEALTH AND WELFARE BENEFITS

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2023-03-01 ASHLEY NOBLE 2024-09-06

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
501	2023-03-01	ASHLEY NOBLE	2024-09-06

Form 5500 Responses for NILE LIVING HEALTH AND WELFARE BENEFITS

2023: NILE LIVING HEALTH AND WELFARE BENEFITS 2023 form 5500 responses
2023-03-01	Type of plan entity	Multi-employer plan
2023-03-01	First time form 5500 has been submitted	Yes
2023-03-01	Plan is a collectively bargained plan	Yes
2023-03-01	Plan funding arrangement – Insurance	Yes
2023-03-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )

Policy contract number

1108315

Policy instance

Insurance contract or identification number	1108315
Number of Individuals Covered	113
Insurance policy start date	2023-03-01
Insurance policy end date	2024-02-29
Total amount of commissions paid to insurance broker	USD $3,404
Total amount of fees paid to insurance company	USD $0
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 $46,421
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST (National Association of Insurance Commissioners NAIC id number: 95540 )

Policy contract number

07906

Policy instance

Insurance contract or identification number	07906
Number of Individuals Covered	80
Insurance policy start date	2023-03-01
Insurance policy end date	2024-02-29
Total amount of commissions paid to insurance broker	USD $13,235
Total amount of fees paid to insurance company	USD $1,000
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $457,465
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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Company Name:	NILE LIVING
Employer identification number (EIN):	824165252
NAIC Classification:	623000
NAIC Description:	Nursing and Residential Care Facilities