401k Plan data: PRESBYTERIAN RETIREMENT COMMUNITIES NORTHWEST GROUP INSURANCE PLAN plan

PRESBYTERIAN RETIREMENT COMMUNITIES NORTHWEST GROUP INSURANCE PLAN 401k Plan overview

Plan Name	PRESBYTERIAN RETIREMENT COMMUNITIES NORTHWEST GROUP INSURANCE PLAN
Plan identification number	501

PRESBYTERIAN RETIREMENT COMMUNITIES NORTHWEST GROUP INSURANCE PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) Life insurance Dental Vision Temporary disability (accident and sickness) Long-term disability cover Death benefits (include travel accident but not life insurance) Other welfare benefit cover

401k Sponsoring company profile

PRESBYTERIAN RETIREMENT COMMUNITIES NORTHWEST has sponsored the creation of one or more 401k plans.

Company Name: PRESBYTERIAN RETIREMENT COMMUNITIES NORTHWEST

Employer identification number (EIN): 910666887

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

Additional information about PRESBYTERIAN RETIREMENT COMMUNITIES NORTHWEST

Jurisdiction of Incorporation: Washington Secretary of State Corporations Division

Incorporation Date: 1956-09-10

Company Identification Number: 578060607

Legal Registered Office Address: 999 3RD AVE STE 4600

SEATTLE
United States of America (USA)
981044084

More information about PRESBYTERIAN RETIREMENT COMMUNITIES NORTHWEST

Form 5500 Filing Information

Submission information for form 5500 for 401k plan PRESBYTERIAN RETIREMENT COMMUNITIES NORTHWEST GROUP INSURANCE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2023-04-01 KAREN BRANDT 2024-10-08
501 2022-04-01 KAREN BRANDT 2023-10-17
501 2021-04-01 KAREN BRANDT 2022-10-31
501 2020-04-01 JULIE HUNTOON 2021-10-13
501 2019-04-01 JULIE HUNTOON 2020-10-14
501 2018-04-01 JULIE HUNTOON 2019-10-25
501 2017-04-01
501 2016-04-01
501 2015-04-01 EVE JAKOBOSKI
501 2015-03-01 EVE JAKOBOSKI
501 2014-03-01 EVE JACOBOSKI
501 2013-03-01 LARRY DART
501 2012-03-01 LARRY DART
501 2011-03-01 LARRY DART
501 2009-03-01 CHARLENE ANDERSON

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
501	2023-04-01	KAREN BRANDT	2024-10-08
501	2022-04-01	KAREN BRANDT	2023-10-17
501	2021-04-01	KAREN BRANDT	2022-10-31
501	2020-04-01	JULIE HUNTOON	2021-10-13
501	2019-04-01	JULIE HUNTOON	2020-10-14
501	2018-04-01	JULIE HUNTOON	2019-10-25
501	2017-04-01
501	2016-04-01
501	2015-04-01	EVE JAKOBOSKI
501	2015-03-01	EVE JAKOBOSKI
501	2014-03-01	EVE JACOBOSKI
501	2013-03-01	LARRY DART
501	2012-03-01	LARRY DART
501	2011-03-01	LARRY DART
501	2009-03-01	CHARLENE ANDERSON

Form 5500 Responses for PRESBYTERIAN RETIREMENT COMMUNITIES NORTHWEST GROUP INSURANCE PLAN

2023: PRESBYTERIAN RETIREMENT COMMUNITIES NORTHWEST GROUP INSURANCE PLAN 2023 form 5500 responses
2023-04-01	Type of plan entity	Single employer plan
2023-04-01	Plan funding arrangement – Insurance	Yes
2023-04-01	Plan funding arrangement – General assets of the sponsor	Yes
2023-04-01	Plan benefit arrangement – Insurance	Yes
2023-04-01	Plan benefit arrangement – General assets of the sponsor	Yes
2022: PRESBYTERIAN RETIREMENT COMMUNITIES NORTHWEST GROUP INSURANCE PLAN 2022 form 5500 responses
2022-04-01	Type of plan entity	Single employer plan
2022-04-01	Plan funding arrangement – Insurance	Yes
2022-04-01	Plan funding arrangement – General assets of the sponsor	Yes
2022-04-01	Plan benefit arrangement – Insurance	Yes
2022-04-01	Plan benefit arrangement – General assets of the sponsor	Yes
2021: PRESBYTERIAN RETIREMENT COMMUNITIES NORTHWEST GROUP INSURANCE PLAN 2021 form 5500 responses
2021-04-01	Type of plan entity	Single employer plan
2021-04-01	Plan funding arrangement – Insurance	Yes
2021-04-01	Plan funding arrangement – General assets of the sponsor	Yes
2021-04-01	Plan benefit arrangement – Insurance	Yes
2021-04-01	Plan benefit arrangement – General assets of the sponsor	Yes
2020: PRESBYTERIAN RETIREMENT COMMUNITIES NORTHWEST GROUP INSURANCE PLAN 2020 form 5500 responses
2020-04-01	Type of plan entity	Single employer plan
2020-04-01	Plan funding arrangement – Insurance	Yes
2020-04-01	Plan funding arrangement – General assets of the sponsor	Yes
2020-04-01	Plan benefit arrangement – Insurance	Yes
2020-04-01	Plan benefit arrangement – General assets of the sponsor	Yes
2019: PRESBYTERIAN RETIREMENT COMMUNITIES NORTHWEST GROUP INSURANCE PLAN 2019 form 5500 responses
2019-04-01	Type of plan entity	Single employer plan
2019-04-01	Plan funding arrangement – Insurance	Yes
2019-04-01	Plan funding arrangement – General assets of the sponsor	Yes
2019-04-01	Plan benefit arrangement – Insurance	Yes
2019-04-01	Plan benefit arrangement – General assets of the sponsor	Yes
2018: PRESBYTERIAN RETIREMENT COMMUNITIES NORTHWEST GROUP INSURANCE PLAN 2018 form 5500 responses
2018-04-01	Type of plan entity	Single employer plan
2018-04-01	Plan funding arrangement – Insurance	Yes
2018-04-01	Plan funding arrangement – General assets of the sponsor	Yes
2018-04-01	Plan benefit arrangement – Insurance	Yes
2018-04-01	Plan benefit arrangement – General assets of the sponsor	Yes
2017: PRESBYTERIAN RETIREMENT COMMUNITIES NORTHWEST GROUP INSURANCE PLAN 2017 form 5500 responses
2017-04-01	Type of plan entity	Single employer plan
2017-04-01	Plan funding arrangement – Insurance	Yes
2017-04-01	Plan benefit arrangement – Insurance	Yes
2016: PRESBYTERIAN RETIREMENT COMMUNITIES NORTHWEST GROUP INSURANCE PLAN 2016 form 5500 responses
2016-04-01	Type of plan entity	Single employer plan
2016-04-01	Submission has been amended	No
2016-04-01	This submission is the final filing	No
2016-04-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-04-01	Plan is a collectively bargained plan	No
2016-04-01	Plan funding arrangement – Insurance	Yes
2016-04-01	Plan benefit arrangement – Insurance	Yes
2015: PRESBYTERIAN RETIREMENT COMMUNITIES NORTHWEST GROUP INSURANCE PLAN 2015 form 5500 responses
2015-04-01	Type of plan entity	Single employer plan
2015-04-01	Submission has been amended	No
2015-04-01	This submission is the final filing	No
2015-04-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-04-01	Plan is a collectively bargained plan	No
2015-04-01	Plan funding arrangement – Insurance	Yes
2015-04-01	Plan benefit arrangement – Insurance	Yes
2015-03-01	Type of plan entity	Single employer plan
2015-03-01	Submission has been amended	No
2015-03-01	This submission is the final filing	No
2015-03-01	This return/report is a short plan year return/report (less than 12 months)	Yes
2015-03-01	Plan is a collectively bargained plan	No
2015-03-01	Plan funding arrangement – Insurance	Yes
2015-03-01	Plan benefit arrangement – Insurance	Yes
2014: PRESBYTERIAN RETIREMENT COMMUNITIES NORTHWEST GROUP INSURANCE PLAN 2014 form 5500 responses
2014-03-01	Type of plan entity	Single employer plan
2014-03-01	Submission has been amended	No
2014-03-01	This submission is the final filing	No
2014-03-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-03-01	Plan is a collectively bargained plan	No
2014-03-01	Plan funding arrangement – Insurance	Yes
2014-03-01	Plan benefit arrangement – Insurance	Yes
2013: PRESBYTERIAN RETIREMENT COMMUNITIES NORTHWEST GROUP INSURANCE PLAN 2013 form 5500 responses
2013-03-01	Type of plan entity	Single employer plan
2013-03-01	Submission has been amended	No
2013-03-01	This submission is the final filing	No
2013-03-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-03-01	Plan is a collectively bargained plan	No
2013-03-01	Plan funding arrangement – Insurance	Yes
2013-03-01	Plan benefit arrangement – Insurance	Yes
2012: PRESBYTERIAN RETIREMENT COMMUNITIES NORTHWEST GROUP INSURANCE PLAN 2012 form 5500 responses
2012-03-01	Type of plan entity	Single employer plan
2012-03-01	Submission has been amended	No
2012-03-01	This submission is the final filing	No
2012-03-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-03-01	Plan is a collectively bargained plan	No
2012-03-01	Plan funding arrangement – Insurance	Yes
2012-03-01	Plan benefit arrangement – Insurance	Yes
2011: PRESBYTERIAN RETIREMENT COMMUNITIES NORTHWEST GROUP INSURANCE PLAN 2011 form 5500 responses
2011-03-01	Type of plan entity	Single employer plan
2011-03-01	Submission has been amended	No
2011-03-01	This submission is the final filing	No
2011-03-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-03-01	Plan is a collectively bargained plan	No
2011-03-01	Plan funding arrangement – Insurance	Yes
2011-03-01	Plan benefit arrangement – Insurance	Yes
2009: PRESBYTERIAN RETIREMENT COMMUNITIES NORTHWEST GROUP INSURANCE PLAN 2009 form 5500 responses
2009-03-01	Type of plan entity	Single employer plan
2009-03-01	Submission has been amended	No
2009-03-01	This submission is the final filing	No
2009-03-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-03-01	Plan is a collectively bargained plan	No
2009-03-01	Plan funding arrangement – Insurance	Yes
2009-03-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

WILLAMETTE DENTAL OF WASHINGTON, INC. (National Association of Insurance Commissioners NAIC id number: 47050 )

Policy contract number

WA799

Policy instance

Insurance contract or identification number	WA799
Number of Individuals Covered	22
Insurance policy start date	2023-04-01
Insurance policy end date	2023-12-31
Total amount of commissions paid to insurance broker	USD $321
Total amount of fees paid to insurance company	USD $0
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

SYMETRA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68608 )

Policy contract number

01-018231-00

Policy instance

Insurance contract or identification number	01-018231-00
Number of Individuals Covered	569
Insurance policy start date	2023-04-01
Insurance policy end date	2024-03-31
Total amount of commissions paid to insurance broker	USD $23,938
Total amount of fees paid to insurance company	USD $6,835
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT, EMPLOYEE ASSISTANCE PROGRAM
Welfare Benefit Premiums Paid to Carrier	USD $129,226
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	Yes

VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 53031 )

Policy contract number

30012882

Policy instance

Insurance contract or identification number	30012882
Number of Individuals Covered	14
Insurance policy start date	2023-04-01
Insurance policy end date	2024-03-31
Total amount of commissions paid to insurance broker	USD $715
Total amount of fees paid to insurance company	USD $0
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $20,463
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

WILLAMETTE DENTAL OF WASHINGTON, INC. (National Association of Insurance Commissioners NAIC id number: 47050 )

Policy contract number

WA799

Policy instance

SYMETRA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68608 )

Policy contract number

101823100

Policy instance

VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 53031 )

Policy contract number

30012882

Policy instance

VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 53031 )

Policy contract number

30012882

Policy instance

SYMETRA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68608 )

Policy contract number

0101823100

Policy instance

SYMETRA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68608 )

Policy contract number

0101823100

Policy instance

VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 53031 )

Policy contract number

30012882

Policy instance

VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 53031 )

Policy contract number

30012882

Policy instance

SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )

Policy contract number

906949

Policy instance

VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 53031 )

Policy contract number

30012882

Policy instance

SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )

Policy contract number

906949

Policy instance

UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )

Policy contract number

126149

Policy instance

VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 53031 )

Policy contract number

30012882

Policy instance

DELTA DENTAL OF WASHINGTON (National Association of Insurance Commissioners NAIC id number: 47341 )

Policy contract number

763

Policy instance

AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )

Policy contract number

231683

Policy instance

GROUP HEALTH OPTIONS, INC. (National Association of Insurance Commissioners NAIC id number: 47055 )

Policy contract number

6497800

Policy instance

UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )

Policy contract number

126149/46812

Policy instance

VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 53031 )

Policy contract number

30012882

Policy instance

DELTA DENTAL OF WASHINGTON (National Association of Insurance Commissioners NAIC id number: 47341 )

Policy contract number

763

Policy instance

GROUP HEALTH COOPERATIVE (National Association of Insurance Commissioners NAIC id number: 95672 )

Policy contract number

1414700

Policy instance

DELTA DENTAL OF WASHINGTON (National Association of Insurance Commissioners NAIC id number: 47341 )

Policy contract number

763

Policy instance

GROUP HEALTH COOPERATIVE (National Association of Insurance Commissioners NAIC id number: 95672 )

Policy contract number

1414700

Policy instance

GROUP HEALTH OPTIONS, INC. (National Association of Insurance Commissioners NAIC id number: 47055 )

Policy contract number

5217300

Policy instance

UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )

Policy contract number

126149/46812

Policy instance

VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 53031 )

Policy contract number

30012882

Policy instance

VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 47317 )

Policy contract number

30012882

Policy instance

GROUP HEALTH OPTIONS, INC. (National Association of Insurance Commissioners NAIC id number: 47055 )

Policy contract number

5217300

Policy instance

GROUP HEALTH COOPERATIVE (National Association of Insurance Commissioners NAIC id number: 95672 )

Policy contract number

1414700

Policy instance

DELTA DENTAL OF WASHINGTON (National Association of Insurance Commissioners NAIC id number: 47341 )

Policy contract number

763

Policy instance

UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )

Policy contract number

126149/46812

Policy instance

VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 47317 )

Policy contract number

30012882

Policy instance

GROUP HEALTH OPTIONS, INC. (National Association of Insurance Commissioners NAIC id number: 47055 )

Policy contract number

5217301/1414700

Policy instance

UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )

Policy contract number

126149/46812

Policy instance

DELTA DENTAL OF WASHINGTON (National Association of Insurance Commissioners NAIC id number: 47341 )

Policy contract number

763

Policy instance

UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )

Policy contract number

126149

Policy instance

DELTA DENTAL OF WASHINGTON (National Association of Insurance Commissioners NAIC id number: 47341 )

Policy contract number

763

Policy instance

GROUP HEALTH OPTIONS, INC. (National Association of Insurance Commissioners NAIC id number: 47055 )

Policy contract number

5217300/6226800

Policy instance

DELTA DENTAL OF WASHINGTON (National Association of Insurance Commissioners NAIC id number: 47341 )

Policy contract number

763

Policy instance

GROUP HEALTH OPTIONS, INC. (National Association of Insurance Commissioners NAIC id number: 47055 )

Policy contract number

5217300

Policy instance

UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )

Policy contract number

126149

Policy instance

GROUP HEALTH OPTIONS, INC. (National Association of Insurance Commissioners NAIC id number: 47055 )

Policy contract number

5217300

Policy instance

UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )

Policy contract number

126149

Policy instance

DELTA DENTAL OF WASHINGTON (National Association of Insurance Commissioners NAIC id number: 47341 )

Policy contract number

763

Policy instance

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Company Name:	PRESBYTERIAN RETIREMENT COMMUNITIES NORTHWEST
Employer identification number (EIN):	910666887
NAIC Classification:	623000
NAIC Description:	Nursing and Residential Care Facilities

Jurisdiction of Incorporation:	Washington Secretary of State Corporations Division
Incorporation Date:	1956-09-10
Company Identification Number:	578060607
Legal Registered Office Address:	999 3RD AVE STE 4600 SEATTLE United States of America (USA) 981044084