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THE MIRROR INC LIFE & DISABILITY PLAN 401k Plan overview

Plan NameTHE MIRROR INC LIFE & DISABILITY PLAN
Plan identification number 501

THE MIRROR INC LIFE & DISABILITY PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Life insurance
  • Temporary disability (accident and sickness)
  • Long-term disability cover
  • Death benefits (include travel accident but not life insurance)

401k Sponsoring company profile

THE MIRROR, INC. has sponsored the creation of one or more 401k plans.

Company Name:THE MIRROR, INC.
Employer identification number (EIN):237433368
NAIC Classification:621420
NAIC Description:Outpatient Mental Health and Substance Abuse Centers

Additional information about THE MIRROR, INC.

Jurisdiction of Incorporation: Florida Department of State Division of Corporations
Incorporation Date: 1970-12-29
Company Identification Number: 374816
Legal Registered Office Address: 6546 PEMBROKE ROAD

MIRAMAR

33023

More information about THE MIRROR, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan THE MIRROR INC LIFE & DISABILITY PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012022-07-01ASHLEY RHODES2023-11-10
5012021-07-01ASHLEY RHODES2023-01-31
5012020-07-01
5012019-07-01
5012018-07-01
5012017-07-01ROBERT MILLE ROBERT MILLE2019-01-12
5012016-07-01ROBERT MILLE ROBERT MILLE2018-01-25
5012015-07-01CHARLES APPLEGATE CHARLES APPLEGATE2017-01-24
5012014-07-01DAVID WUTHNOW DAVID WUTHNOW2016-02-15

Plan Statistics for THE MIRROR INC LIFE & DISABILITY PLAN

401k plan membership statisitcs for THE MIRROR INC LIFE & DISABILITY PLAN

Measure Date Value
2022: THE MIRROR INC LIFE & DISABILITY PLAN 2022 401k membership
Total participants, beginning-of-year2022-07-01181
Total number of active participants reported on line 7a of the Form 55002022-07-01145
Number of retired or separated participants receiving benefits2022-07-010
Number of other retired or separated participants entitled to future benefits2022-07-010
Total of all active and inactive participants2022-07-01145
Number of employers contributing to the scheme2022-07-010
2021: THE MIRROR INC LIFE & DISABILITY PLAN 2021 401k membership
Total participants, beginning-of-year2021-07-01190
Total number of active participants reported on line 7a of the Form 55002021-07-01227
Number of retired or separated participants receiving benefits2021-07-010
Number of other retired or separated participants entitled to future benefits2021-07-010
Total of all active and inactive participants2021-07-01227
Number of employers contributing to the scheme2021-07-010
2020: THE MIRROR INC LIFE & DISABILITY PLAN 2020 401k membership
Total participants, beginning-of-year2020-07-01190
Total number of active participants reported on line 7a of the Form 55002020-07-01208
Total of all active and inactive participants2020-07-01208
2019: THE MIRROR INC LIFE & DISABILITY PLAN 2019 401k membership
Total participants, beginning-of-year2019-07-01177
Total number of active participants reported on line 7a of the Form 55002019-07-01190
Total of all active and inactive participants2019-07-01190
2018: THE MIRROR INC LIFE & DISABILITY PLAN 2018 401k membership
Total participants, beginning-of-year2018-07-01147
Total number of active participants reported on line 7a of the Form 55002018-07-01177
Total of all active and inactive participants2018-07-01177
2017: THE MIRROR INC LIFE & DISABILITY PLAN 2017 401k membership
Total participants, beginning-of-year2017-07-01130
Total number of active participants reported on line 7a of the Form 55002017-07-01147
Total of all active and inactive participants2017-07-01147
2016: THE MIRROR INC LIFE & DISABILITY PLAN 2016 401k membership
Total participants, beginning-of-year2016-07-01147
Total number of active participants reported on line 7a of the Form 55002016-07-01130
Total of all active and inactive participants2016-07-01130
2015: THE MIRROR INC LIFE & DISABILITY PLAN 2015 401k membership
Total participants, beginning-of-year2015-07-01144
Total number of active participants reported on line 7a of the Form 55002015-07-01147
Total of all active and inactive participants2015-07-01147
2014: THE MIRROR INC LIFE & DISABILITY PLAN 2014 401k membership
Total participants, beginning-of-year2014-07-01114
Total number of active participants reported on line 7a of the Form 55002014-07-01144
Total of all active and inactive participants2014-07-01144

Form 5500 Responses for THE MIRROR INC LIFE & DISABILITY PLAN

2022: THE MIRROR INC LIFE & DISABILITY PLAN 2022 form 5500 responses
2022-07-01Type of plan entitySingle employer plan
2022-07-01Plan funding arrangement – InsuranceYes
2022-07-01Plan benefit arrangement – InsuranceYes
2021: THE MIRROR INC LIFE & DISABILITY PLAN 2021 form 5500 responses
2021-07-01Type of plan entitySingle employer plan
2021-07-01Plan funding arrangement – InsuranceYes
2021-07-01Plan benefit arrangement – InsuranceYes
2020: THE MIRROR INC LIFE & DISABILITY PLAN 2020 form 5500 responses
2020-07-01Type of plan entitySingle employer plan
2020-07-01Plan funding arrangement – InsuranceYes
2020-07-01Plan funding arrangement – General assets of the sponsorYes
2020-07-01Plan benefit arrangement – InsuranceYes
2020-07-01Plan benefit arrangement – General assets of the sponsorYes
2019: THE MIRROR INC LIFE & DISABILITY PLAN 2019 form 5500 responses
2019-07-01Type of plan entitySingle employer plan
2019-07-01Plan funding arrangement – InsuranceYes
2019-07-01Plan funding arrangement – General assets of the sponsorYes
2019-07-01Plan benefit arrangement – InsuranceYes
2019-07-01Plan benefit arrangement – General assets of the sponsorYes
2018: THE MIRROR INC LIFE & DISABILITY PLAN 2018 form 5500 responses
2018-07-01Type of plan entitySingle employer plan
2018-07-01Plan funding arrangement – InsuranceYes
2018-07-01Plan funding arrangement – General assets of the sponsorYes
2018-07-01Plan benefit arrangement – InsuranceYes
2018-07-01Plan benefit arrangement – General assets of the sponsorYes
2017: THE MIRROR INC LIFE & DISABILITY PLAN 2017 form 5500 responses
2017-07-01Type of plan entitySingle employer plan
2017-07-01Plan funding arrangement – InsuranceYes
2017-07-01Plan funding arrangement – General assets of the sponsorYes
2017-07-01Plan benefit arrangement – InsuranceYes
2017-07-01Plan benefit arrangement – General assets of the sponsorYes
2016: THE MIRROR INC LIFE & DISABILITY PLAN 2016 form 5500 responses
2016-07-01Type of plan entitySingle employer plan
2016-07-01Plan funding arrangement – InsuranceYes
2016-07-01Plan funding arrangement – General assets of the sponsorYes
2016-07-01Plan benefit arrangement – InsuranceYes
2016-07-01Plan benefit arrangement – General assets of the sponsorYes
2015: THE MIRROR INC LIFE & DISABILITY PLAN 2015 form 5500 responses
2015-07-01Type of plan entitySingle employer plan
2015-07-01Plan funding arrangement – InsuranceYes
2015-07-01Plan funding arrangement – General assets of the sponsorYes
2015-07-01Plan benefit arrangement – InsuranceYes
2015-07-01Plan benefit arrangement – General assets of the sponsorYes
2014: THE MIRROR INC LIFE & DISABILITY PLAN 2014 form 5500 responses
2014-07-01Type of plan entitySingle employer plan
2014-07-01First time form 5500 has been submittedYes
2014-07-01Plan funding arrangement – InsuranceYes
2014-07-01Plan funding arrangement – General assets of the sponsorYes
2014-07-01Plan benefit arrangement – InsuranceYes
2014-07-01Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number370211
Policy instance 1
Insurance contract or identification number370211
Number of Individuals Covered175
Insurance policy start date2022-07-01
Insurance policy end date2023-06-30
Total amount of commissions paid to insurance brokerUSD $7,793
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $55,630
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,793
Amount paid for insurance broker fees0
Insurance broker organization code?3
ADVANCE INSURANCE COMPANY OF KANSAS (National Association of Insurance Commissioners NAIC id number: 12143 )
Policy contract number9165
Policy instance 1
Insurance contract or identification number9165
Number of Individuals Covered227
Insurance policy start date2021-07-01
Insurance policy end date2022-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $62,360
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
ADVANCE INSURANCE COMPANY OF KANSAS (National Association of Insurance Commissioners NAIC id number: 12143 )
Policy contract number00009165
Policy instance 1
Insurance contract or identification number00009165
Number of Individuals Covered208
Insurance policy start date2020-07-01
Insurance policy end date2021-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $51,712
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
ADVANCE INSURANCE COMPANY OF KANSAS (National Association of Insurance Commissioners NAIC id number: 12143 )
Policy contract number00009165
Policy instance 1
Insurance contract or identification number00009165
Number of Individuals Covered190
Insurance policy start date2019-07-01
Insurance policy end date2020-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $46,802
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
ADVANCE INSURANCE COMPANY OF KANSAS (National Association of Insurance Commissioners NAIC id number: 12143 )
Policy contract number00009165
Policy instance 1
Insurance contract or identification number00009165
Number of Individuals Covered177
Insurance policy start date2018-07-01
Insurance policy end date2019-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $45,823
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
ADVANCE INSURANCE COMPANY OF KANSAS (National Association of Insurance Commissioners NAIC id number: 12143 )
Policy contract number00009165
Policy instance 1
Insurance contract or identification number00009165
Number of Individuals Covered147
Insurance policy start date2017-07-01
Insurance policy end date2018-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $33,609
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
ADVANCE INSURANCE COMPANY OF KANSAS (National Association of Insurance Commissioners NAIC id number: 12143 )
Policy contract number00009165
Policy instance 1
Insurance contract or identification number00009165
Number of Individuals Covered147
Insurance policy start date2015-07-01
Insurance policy end date2016-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $26,468
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
ADVANCE INSURANCE COMPANY OF KANSAS (National Association of Insurance Commissioners NAIC id number: 12143 )
Policy contract number00009165
Policy instance 1
Insurance contract or identification number00009165
Number of Individuals Covered144
Insurance policy start date2014-07-01
Insurance policy end date2015-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $27,347
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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