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THE COTTAGES AT GARDEN GROVE 401k Plan overview

Plan NameTHE COTTAGES AT GARDEN GROVE
Plan identification number 501

THE COTTAGES AT GARDEN GROVE Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Life insurance

401k Sponsoring company profile

PLAZA NURSING HOME COMPANY, INC. has sponsored the creation of one or more 401k plans.

Company Name:PLAZA NURSING HOME COMPANY, INC.
Employer identification number (EIN):160955793
NAIC Classification:623000
NAIC Description: Nursing and Residential Care Facilities

Additional information about PLAZA NURSING HOME COMPANY, INC.

Jurisdiction of Incorporation: New York Department of State
Incorporation Date: 1968-08-02
Company Identification Number: 226517

More information about PLAZA NURSING HOME COMPANY, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan THE COTTAGES AT GARDEN GROVE

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012018-12-01
5012017-12-01
5012016-12-01ADAM FITZGERALD ADAM FITZGERALD2018-06-12
5012015-12-01ADAM FITZGERALD ADAM FITZGERALD2017-05-22
5012014-12-01ADAM FITZGERALD ADAM FITZGERALD2016-07-22

Plan Statistics for THE COTTAGES AT GARDEN GROVE

401k plan membership statisitcs for THE COTTAGES AT GARDEN GROVE

Measure Date Value
2018: THE COTTAGES AT GARDEN GROVE 2018 401k membership
Total participants, beginning-of-year2018-12-01119
Total number of active participants reported on line 7a of the Form 55002018-12-01119
Number of retired or separated participants receiving benefits2018-12-010
Total of all active and inactive participants2018-12-01119
Total participants2018-12-01119
2017: THE COTTAGES AT GARDEN GROVE 2017 401k membership
Total participants, beginning-of-year2017-12-01121
Total number of active participants reported on line 7a of the Form 55002017-12-01126
Number of retired or separated participants receiving benefits2017-12-017
Total of all active and inactive participants2017-12-01133
Total participants2017-12-01133
2016: THE COTTAGES AT GARDEN GROVE 2016 401k membership
Total participants, beginning-of-year2016-12-01119
Total number of active participants reported on line 7a of the Form 55002016-12-01121
Number of retired or separated participants receiving benefits2016-12-018
Total of all active and inactive participants2016-12-01129
Total participants2016-12-01129
2015: THE COTTAGES AT GARDEN GROVE 2015 401k membership
Total participants, beginning-of-year2015-12-01134
Total number of active participants reported on line 7a of the Form 55002015-12-01119
Number of retired or separated participants receiving benefits2015-12-018
Total of all active and inactive participants2015-12-01127
Total participants2015-12-01127
2014: THE COTTAGES AT GARDEN GROVE 2014 401k membership
Total participants, beginning-of-year2014-12-01172
Total number of active participants reported on line 7a of the Form 55002014-12-01172
Number of retired or separated participants receiving benefits2014-12-018
Total of all active and inactive participants2014-12-01180
Total participants2014-12-01180

Form 5500 Responses for THE COTTAGES AT GARDEN GROVE

2018: THE COTTAGES AT GARDEN GROVE 2018 form 5500 responses
2018-12-01Type of plan entitySingle employer plan
2018-12-01First time form 5500 has been submittedYes
2018-12-01Submission has been amendedNo
2018-12-01This submission is the final filingNo
2018-12-01This return/report is a short plan year return/report (less than 12 months)No
2018-12-01Plan is a collectively bargained planNo
2018-12-01Plan funding arrangement – InsuranceYes
2018-12-01Plan benefit arrangement – InsuranceYes
2017: THE COTTAGES AT GARDEN GROVE 2017 form 5500 responses
2017-12-01Type of plan entitySingle employer plan
2017-12-01First time form 5500 has been submittedYes
2017-12-01Submission has been amendedNo
2017-12-01This submission is the final filingNo
2017-12-01This return/report is a short plan year return/report (less than 12 months)No
2017-12-01Plan is a collectively bargained planNo
2017-12-01Plan funding arrangement – InsuranceYes
2017-12-01Plan benefit arrangement – InsuranceYes
2016: THE COTTAGES AT GARDEN GROVE 2016 form 5500 responses
2016-12-01Type of plan entitySingle employer plan
2016-12-01First time form 5500 has been submittedYes
2016-12-01Submission has been amendedNo
2016-12-01This submission is the final filingNo
2016-12-01This return/report is a short plan year return/report (less than 12 months)No
2016-12-01Plan is a collectively bargained planNo
2016-12-01Plan funding arrangement – InsuranceYes
2016-12-01Plan benefit arrangement – InsuranceYes
2015: THE COTTAGES AT GARDEN GROVE 2015 form 5500 responses
2015-12-01Type of plan entitySingle employer plan
2015-12-01First time form 5500 has been submittedYes
2015-12-01Submission has been amendedNo
2015-12-01This submission is the final filingNo
2015-12-01This return/report is a short plan year return/report (less than 12 months)No
2015-12-01Plan is a collectively bargained planNo
2015-12-01Plan funding arrangement – InsuranceYes
2015-12-01Plan benefit arrangement – InsuranceYes
2014: THE COTTAGES AT GARDEN GROVE 2014 form 5500 responses
2014-12-01Type of plan entitySingle employer plan
2014-12-01First time form 5500 has been submittedYes
2014-12-01Submission has been amendedNo
2014-12-01This submission is the final filingNo
2014-12-01This return/report is a short plan year return/report (less than 12 months)No
2014-12-01Plan is a collectively bargained planNo
2014-12-01Plan funding arrangement – InsuranceYes
2014-12-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

SECURITY MUTUAL LIFE INSURANCE COMPANY OF NY (National Association of Insurance Commissioners NAIC id number: 68772 )
Policy contract number000002668
Policy instance 1
Insurance contract or identification number000002668
Number of Individuals Covered119
Insurance policy start date2018-12-01
Insurance policy end date2019-11-30
Total amount of commissions paid to insurance brokerUSD $1,489
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,489
Insurance broker organization code?3
SECURITY MUTUAL LIFE INSURANCE COMPANY OF NY (National Association of Insurance Commissioners NAIC id number: 68772 )
Policy contract numberG-2668
Policy instance 1
Insurance contract or identification numberG-2668
Number of Individuals Covered126
Insurance policy start date2017-12-01
Insurance policy end date2018-11-30
Total amount of commissions paid to insurance brokerUSD $1,473
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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