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| Plan Name | TRANSFORMING AGE ASSOCIATES WRAP PLAN |
| Plan identification number | 501 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | TRANSFORMING AGE ASSOCIATES, LLC |
| Employer identification number (EIN): | 920770430 |
| NAIC Classification: | 623000 |
| NAIC Description: | Nursing and Residential Care Facilities |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 501 | 2023-01-01 | KAREN BRANDT | 2024-05-14 |
| Measure | Date | Value |
|---|---|---|
| 2023: TRANSFORMING AGE ASSOCIATES WRAP PLAN 2023 401k membership | ||
| Total participants, beginning-of-year | 2023-01-01 | 100 |
| Total number of active participants reported on line 7a of the Form 5500 | 2023-01-01 | 181 |
| Number of retired or separated participants receiving benefits | 2023-01-01 | 1 |
| Number of other retired or separated participants entitled to future benefits | 2023-01-01 | 0 |
| Total of all active and inactive participants | 2023-01-01 | 182 |
| Number of employers contributing to the scheme | 2023-01-01 | 0 |
| 2023: TRANSFORMING AGE ASSOCIATES WRAP PLAN 2023 form 5500 responses | ||
|---|---|---|
| 2023-01-01 | Type of plan entity | Single employer plan |
| 2023-01-01 | First time form 5500 has been submitted | Yes |
| 2023-01-01 | Plan funding arrangement – Insurance | Yes |
| 2023-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2023-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2023-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| WILLAMETTE DENTAL OF WASHINGTON, INC. (National Association of Insurance Commissioners NAIC id number: 47050 ) | |||||||||||||||||||||||||
| Policy contract number | WA864 | ||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||
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| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 53031 ) | |||||||||||||||||||||||||
| Policy contract number | 40153370 | ||||||||||||||||||||||||
| Policy instance | 2 | ||||||||||||||||||||||||
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| SYMETRA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68608 ) | |||||||||||||||||||||||||
| Policy contract number | 01-020594-00 | ||||||||||||||||||||||||
| Policy instance | 3 | ||||||||||||||||||||||||
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