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ACTIVCARE LIVING HEALTH PLAN 401k Plan overview

Plan NameACTIVCARE LIVING HEALTH PLAN
Plan identification number 510

ACTIVCARE LIVING HEALTH PLAN Benefits

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

401k Sponsoring company profile

ACTIVCARE LIVING, INC. has sponsored the creation of one or more 401k plans.

Company Name:ACTIVCARE LIVING, INC.
Employer identification number (EIN):953696840
NAIC Classification:623000
NAIC Description: Nursing and Residential Care Facilities

Additional information about ACTIVCARE LIVING, INC.

Jurisdiction of Incorporation: Texas Secretary of State
Incorporation Date: 1997-07-30
Company Identification Number: 0011637906
Legal Registered Office Address: 9619 CHESAPEAKE DR STE 103

SAN DIEGO
United States of America (USA)
92123

More information about ACTIVCARE LIVING, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan ACTIVCARE LIVING HEALTH PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5102021-01-01
5102017-01-01DEBORAH MURPHY
5102016-01-01DEBORAH MURPHY
5102015-01-01DEBORAH MURPHY
5102014-01-01DEBORAH MURPHY
5102013-01-01DEBORAH MURPHY
5102012-01-01DEBORAH MURPHY
5102011-01-01DEBORAH MURPHY
5102010-01-01DEBORAH MURPHY
5102009-01-01DEBORAH MURPHY

Plan Statistics for ACTIVCARE LIVING HEALTH PLAN

401k plan membership statisitcs for ACTIVCARE LIVING HEALTH PLAN

Measure Date Value
2021: ACTIVCARE LIVING HEALTH PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-01171
Total number of active participants reported on line 7a of the Form 55002021-01-01173
Total of all active and inactive participants2021-01-01173
Total participants2021-01-01173
2017: ACTIVCARE LIVING HEALTH PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-01113
Total number of active participants reported on line 7a of the Form 55002017-01-01134
Total of all active and inactive participants2017-01-01134
Total participants2017-01-01134
2016: ACTIVCARE LIVING HEALTH PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-0173
Total number of active participants reported on line 7a of the Form 55002016-01-01113
Total of all active and inactive participants2016-01-01113
Total participants2016-01-01113
2015: ACTIVCARE LIVING HEALTH PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-0145
Total number of active participants reported on line 7a of the Form 55002015-01-0173
Total of all active and inactive participants2015-01-0173
Total participants2015-01-010
2014: ACTIVCARE LIVING HEALTH PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-0136
Total number of active participants reported on line 7a of the Form 55002014-01-0145
Total of all active and inactive participants2014-01-0145
Total participants2014-01-010
2013: ACTIVCARE LIVING HEALTH PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-0131
Total number of active participants reported on line 7a of the Form 55002013-01-0136
Total of all active and inactive participants2013-01-0136
Total participants2013-01-010
2012: ACTIVCARE LIVING HEALTH PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-0136
Total number of active participants reported on line 7a of the Form 55002012-01-0131
Total of all active and inactive participants2012-01-0131
Total participants2012-01-010
2011: ACTIVCARE LIVING HEALTH PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-0188
Total number of active participants reported on line 7a of the Form 55002011-01-0180
Total of all active and inactive participants2011-01-0180
Total participants2011-01-0180
2010: ACTIVCARE LIVING HEALTH PLAN 2010 401k membership
Total participants, beginning-of-year2010-01-0175
Total number of active participants reported on line 7a of the Form 55002010-01-0188
Total of all active and inactive participants2010-01-0188
Total participants2010-01-0188
2009: ACTIVCARE LIVING HEALTH PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-0187
Total number of active participants reported on line 7a of the Form 55002009-01-0175
Total of all active and inactive participants2009-01-0175
Total participants2009-01-0175

Form 5500 Responses for ACTIVCARE LIVING HEALTH PLAN

2021: ACTIVCARE LIVING HEALTH PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan benefit arrangement – InsuranceYes
2017: ACTIVCARE LIVING HEALTH PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan benefit arrangement – InsuranceYes
2016: ACTIVCARE LIVING HEALTH PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan benefit arrangement – InsuranceYes
2015: ACTIVCARE LIVING HEALTH PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan benefit arrangement – InsuranceYes
2014: ACTIVCARE LIVING HEALTH PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan benefit arrangement – InsuranceYes
2013: ACTIVCARE LIVING HEALTH PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan benefit arrangement – InsuranceYes
2012: ACTIVCARE LIVING HEALTH PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan benefit arrangement – InsuranceYes
2011: ACTIVCARE LIVING HEALTH PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan benefit arrangement – InsuranceYes
2010: ACTIVCARE LIVING HEALTH PLAN 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01Plan funding arrangement – InsuranceYes
2010-01-01Plan benefit arrangement – InsuranceYes
2009: ACTIVCARE LIVING HEALTH PLAN 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract number229094
Policy instance 1
Insurance contract or identification number229094
Number of Individuals Covered173
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of fees paid to insurance companyUSD $1,557
Welfare Benefit Premiums Paid to CarrierUSD $968,034
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees1557
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract number229094
Policy instance 1
Insurance contract or identification number229094
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Welfare Benefit Premiums Paid to CarrierUSD $513,669
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract number229094
Policy instance 1
Insurance contract or identification number229094
Number of Individuals Covered73
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Welfare Benefit Premiums Paid to CarrierUSD $326,745
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract number229094
Policy instance 1
Insurance contract or identification number229094
Number of Individuals Covered45
Welfare Benefit Premiums Paid to CarrierUSD $210,290
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract number229094
Policy instance 1
Insurance contract or identification number229094
Number of Individuals Covered36
Welfare Benefit Premiums Paid to CarrierUSD $147,628
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract number229094
Policy instance 1
Insurance contract or identification number229094
Number of Individuals Covered31
Total amount of commissions paid to insurance brokerUSD $106
Welfare Benefit Premiums Paid to CarrierUSD $127,547
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $106
Insurance broker organization code?3
Insurance broker nameHUB INTERNATIONAL OF CA INS SVCES
HEALTH NET (National Association of Insurance Commissioners NAIC id number: 00623 )
Policy contract number
Policy instance 1
Number of Individuals Covered56
Total amount of commissions paid to insurance brokerUSD $3,678
Welfare Benefit Premiums Paid to CarrierUSD $232,917
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract number229094
Policy instance 2
Insurance contract or identification number229094
Number of Individuals Covered12
Total amount of commissions paid to insurance brokerUSD $2,665
Welfare Benefit Premiums Paid to CarrierUSD $148,801
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract number229094
Policy instance 1
Insurance contract or identification number229094
Number of Individuals Covered88
Total amount of commissions paid to insurance brokerUSD $8,953
Welfare Benefit Premiums Paid to CarrierUSD $515,595
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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