401k Plan data: THE WILLIAMSPORT HOME LIFE AND AD&D PLAN plan

THE WILLIAMSPORT HOME LIFE AND AD&D PLAN 401k Plan overview

Plan Name	THE WILLIAMSPORT HOME LIFE AND AD&D PLAN
Plan identification number	502

THE WILLIAMSPORT HOME LIFE AND AD&D PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Life insurance Other welfare benefit cover

401k Sponsoring company profile

THE WILLIAMSPORT HOME LIFE AND AD&D PLAN has sponsored the creation of one or more 401k plans.

Company Name: THE WILLIAMSPORT HOME LIFE AND AD&D PLAN

Employer identification number (EIN): 240795507

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

Form 5500 Filing Information

Submission information for form 5500 for 401k plan THE WILLIAMSPORT HOME LIFE AND AD&D PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
502 2023-09-01 JENNIFER CISNEROS 2024-11-18
502 2022-09-01 DONALD S. POTE 2024-01-12
502 2021-09-01 DONALD S. POTE 2023-01-23
502 2020-09-01 DONALD S. POTE 2021-12-16
502 2019-09-01 DONALD S. POTE 2020-11-20
502 2018-09-01 DONALD S. POTE 2020-04-19
502 2017-09-01
502 2016-09-01
502 2015-09-01
502 2014-09-01
502 2013-09-01
502 2012-09-01 DONALD S. POTE
502 2011-09-01 DONALD S. POTE
502 2009-09-01 DONALD S. POTE
502 2008-09-01 DONALD S. POTE
502 2007-09-01 DONALD S. POTE
502 2006-09-01 DONALD S. POTE
502 2006-09-01 DONALD S. POTE
502 2005-09-01 DONALD S. POTE
502 2004-09-01 DONALD S. POTE

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
502	2023-09-01	JENNIFER CISNEROS	2024-11-18
502	2022-09-01	DONALD S. POTE	2024-01-12
502	2021-09-01	DONALD S. POTE	2023-01-23
502	2020-09-01	DONALD S. POTE	2021-12-16
502	2019-09-01	DONALD S. POTE	2020-11-20
502	2018-09-01	DONALD S. POTE	2020-04-19
502	2017-09-01
502	2016-09-01
502	2015-09-01
502	2014-09-01
502	2013-09-01
502	2012-09-01	DONALD S. POTE
502	2011-09-01	DONALD S. POTE
502	2009-09-01	DONALD S. POTE
502	2008-09-01	DONALD S. POTE
502	2007-09-01	DONALD S. POTE
502	2006-09-01	DONALD S. POTE
502	2006-09-01	DONALD S. POTE
502	2005-09-01	DONALD S. POTE
502	2004-09-01	DONALD S. POTE

Plan Statistics for THE WILLIAMSPORT HOME LIFE AND AD&D PLAN

401k plan membership statisitcs for THE WILLIAMSPORT HOME LIFE AND AD&D PLAN

Measure Date Value
2023: THE WILLIAMSPORT HOME LIFE AND AD&D PLAN 2023 401k membership
Total participants, beginning-of-year 2023-09-01 118
Total number of active participants reported on line 7a of the Form 5500 2023-09-01 108
Total of all active and inactive participants 2023-09-01 108
Total participants 2023-09-01 108
2022: THE WILLIAMSPORT HOME LIFE AND AD&D PLAN 2022 401k membership
Total participants, beginning-of-year 2022-09-01 116
Total number of active participants reported on line 7a of the Form 5500 2022-09-01 118
Total of all active and inactive participants 2022-09-01 118
Total participants 2022-09-01 118
2021: THE WILLIAMSPORT HOME LIFE AND AD&D PLAN 2021 401k membership
Total participants, beginning-of-year 2021-09-01 159
Total number of active participants reported on line 7a of the Form 5500 2021-09-01 116
Total of all active and inactive participants 2021-09-01 116
Total participants 2021-09-01 116
2020: THE WILLIAMSPORT HOME LIFE AND AD&D PLAN 2020 401k membership
Total participants, beginning-of-year 2020-09-01 177
Total number of active participants reported on line 7a of the Form 5500 2020-09-01 159
Total of all active and inactive participants 2020-09-01 159
2019: THE WILLIAMSPORT HOME LIFE AND AD&D PLAN 2019 401k membership
Total participants, beginning-of-year 2019-09-01 172
Total number of active participants reported on line 7a of the Form 5500 2019-09-01 177
Total of all active and inactive participants 2019-09-01 177
2018: THE WILLIAMSPORT HOME LIFE AND AD&D PLAN 2018 401k membership
Total participants, beginning-of-year 2018-09-01 170
Total number of active participants reported on line 7a of the Form 5500 2018-09-01 172
Total of all active and inactive participants 2018-09-01 172
2017: THE WILLIAMSPORT HOME LIFE AND AD&D PLAN 2017 401k membership
Total participants, beginning-of-year 2017-09-01 175
Total number of active participants reported on line 7a of the Form 5500 2017-09-01 170
Total of all active and inactive participants 2017-09-01 170
2016: THE WILLIAMSPORT HOME LIFE AND AD&D PLAN 2016 401k membership
Total participants, beginning-of-year 2016-09-01 167
Total number of active participants reported on line 7a of the Form 5500 2016-09-01 175
Total of all active and inactive participants 2016-09-01 175
2015: THE WILLIAMSPORT HOME LIFE AND AD&D PLAN 2015 401k membership
Total participants, beginning-of-year 2015-09-01 166
Total number of active participants reported on line 7a of the Form 5500 2015-09-01 167
Total of all active and inactive participants 2015-09-01 167
2014: THE WILLIAMSPORT HOME LIFE AND AD&D PLAN 2014 401k membership
Total participants, beginning-of-year 2014-09-01 171
Total number of active participants reported on line 7a of the Form 5500 2014-09-01 166
Total of all active and inactive participants 2014-09-01 166
2013: THE WILLIAMSPORT HOME LIFE AND AD&D PLAN 2013 401k membership
Total participants, beginning-of-year 2013-09-01 173
Total number of active participants reported on line 7a of the Form 5500 2013-09-01 171
Total of all active and inactive participants 2013-09-01 171
2012: THE WILLIAMSPORT HOME LIFE AND AD&D PLAN 2012 401k membership
Total participants, beginning-of-year 2012-09-01 172
Total number of active participants reported on line 7a of the Form 5500 2012-09-01 173
Total of all active and inactive participants 2012-09-01 173
2011: THE WILLIAMSPORT HOME LIFE AND AD&D PLAN 2011 401k membership
Total participants, beginning-of-year 2011-09-01 180
Total number of active participants reported on line 7a of the Form 5500 2011-09-01 172
Total of all active and inactive participants 2011-09-01 172
2009: THE WILLIAMSPORT HOME LIFE AND AD&D PLAN 2009 401k membership
Total participants, beginning-of-year 2009-09-01 187
Total number of active participants reported on line 7a of the Form 5500 2009-09-01 179
Total of all active and inactive participants 2009-09-01 179
2008: THE WILLIAMSPORT HOME LIFE AND AD&D PLAN 2008 401k membership
Total participants, beginning-of-year 2008-09-01 167
Total number of active participants reported on line 7a of the Form 5500 2008-09-01 187
Total of all active and inactive participants 2008-09-01 187
2007: THE WILLIAMSPORT HOME LIFE AND AD&D PLAN 2007 401k membership
Total participants, beginning-of-year 2007-09-01 167
Total number of active participants reported on line 7a of the Form 5500 2007-09-01 158
Total of all active and inactive participants 2007-09-01 158
2006: THE WILLIAMSPORT HOME LIFE AND AD&D PLAN 2006 401k membership
Total participants, beginning-of-year 2006-09-01 152
Total number of active participants reported on line 7a of the Form 5500 2006-09-01 167
Total of all active and inactive participants 2006-09-01 167
2005: THE WILLIAMSPORT HOME LIFE AND AD&D PLAN 2005 401k membership
Total participants, beginning-of-year 2005-09-01 156
Total number of active participants reported on line 7a of the Form 5500 2005-09-01 152
Total of all active and inactive participants 2005-09-01 152
2004: THE WILLIAMSPORT HOME LIFE AND AD&D PLAN 2004 401k membership
Total participants, beginning-of-year 2004-09-01 156
Total number of active participants reported on line 7a of the Form 5500 2004-09-01 156
Total of all active and inactive participants 2004-09-01 156

Measure	Date	Value
2023: THE WILLIAMSPORT HOME LIFE AND AD&D PLAN 2023 401k membership
Total participants, beginning-of-year	2023-09-01	118
Total number of active participants reported on line 7a of the Form 5500	2023-09-01	108
Total of all active and inactive participants	2023-09-01	108
Total participants	2023-09-01	108
2022: THE WILLIAMSPORT HOME LIFE AND AD&D PLAN 2022 401k membership
Total participants, beginning-of-year	2022-09-01	116
Total number of active participants reported on line 7a of the Form 5500	2022-09-01	118
Total of all active and inactive participants	2022-09-01	118
Total participants	2022-09-01	118
2021: THE WILLIAMSPORT HOME LIFE AND AD&D PLAN 2021 401k membership
Total participants, beginning-of-year	2021-09-01	159
Total number of active participants reported on line 7a of the Form 5500	2021-09-01	116
Total of all active and inactive participants	2021-09-01	116
Total participants	2021-09-01	116
2020: THE WILLIAMSPORT HOME LIFE AND AD&D PLAN 2020 401k membership
Total participants, beginning-of-year	2020-09-01	177
Total number of active participants reported on line 7a of the Form 5500	2020-09-01	159
Total of all active and inactive participants	2020-09-01	159
2019: THE WILLIAMSPORT HOME LIFE AND AD&D PLAN 2019 401k membership
Total participants, beginning-of-year	2019-09-01	172
Total number of active participants reported on line 7a of the Form 5500	2019-09-01	177
Total of all active and inactive participants	2019-09-01	177
2018: THE WILLIAMSPORT HOME LIFE AND AD&D PLAN 2018 401k membership
Total participants, beginning-of-year	2018-09-01	170
Total number of active participants reported on line 7a of the Form 5500	2018-09-01	172
Total of all active and inactive participants	2018-09-01	172
2017: THE WILLIAMSPORT HOME LIFE AND AD&D PLAN 2017 401k membership
Total participants, beginning-of-year	2017-09-01	175
Total number of active participants reported on line 7a of the Form 5500	2017-09-01	170
Total of all active and inactive participants	2017-09-01	170
2016: THE WILLIAMSPORT HOME LIFE AND AD&D PLAN 2016 401k membership
Total participants, beginning-of-year	2016-09-01	167
Total number of active participants reported on line 7a of the Form 5500	2016-09-01	175
Total of all active and inactive participants	2016-09-01	175
2015: THE WILLIAMSPORT HOME LIFE AND AD&D PLAN 2015 401k membership
Total participants, beginning-of-year	2015-09-01	166
Total number of active participants reported on line 7a of the Form 5500	2015-09-01	167
Total of all active and inactive participants	2015-09-01	167
2014: THE WILLIAMSPORT HOME LIFE AND AD&D PLAN 2014 401k membership
Total participants, beginning-of-year	2014-09-01	171
Total number of active participants reported on line 7a of the Form 5500	2014-09-01	166
Total of all active and inactive participants	2014-09-01	166
2013: THE WILLIAMSPORT HOME LIFE AND AD&D PLAN 2013 401k membership
Total participants, beginning-of-year	2013-09-01	173
Total number of active participants reported on line 7a of the Form 5500	2013-09-01	171
Total of all active and inactive participants	2013-09-01	171
2012: THE WILLIAMSPORT HOME LIFE AND AD&D PLAN 2012 401k membership
Total participants, beginning-of-year	2012-09-01	172
Total number of active participants reported on line 7a of the Form 5500	2012-09-01	173
Total of all active and inactive participants	2012-09-01	173
2011: THE WILLIAMSPORT HOME LIFE AND AD&D PLAN 2011 401k membership
Total participants, beginning-of-year	2011-09-01	180
Total number of active participants reported on line 7a of the Form 5500	2011-09-01	172
Total of all active and inactive participants	2011-09-01	172
2009: THE WILLIAMSPORT HOME LIFE AND AD&D PLAN 2009 401k membership
Total participants, beginning-of-year	2009-09-01	187
Total number of active participants reported on line 7a of the Form 5500	2009-09-01	179
Total of all active and inactive participants	2009-09-01	179
2008: THE WILLIAMSPORT HOME LIFE AND AD&D PLAN 2008 401k membership
Total participants, beginning-of-year	2008-09-01	167
Total number of active participants reported on line 7a of the Form 5500	2008-09-01	187
Total of all active and inactive participants	2008-09-01	187
2007: THE WILLIAMSPORT HOME LIFE AND AD&D PLAN 2007 401k membership
Total participants, beginning-of-year	2007-09-01	167
Total number of active participants reported on line 7a of the Form 5500	2007-09-01	158
Total of all active and inactive participants	2007-09-01	158
2006: THE WILLIAMSPORT HOME LIFE AND AD&D PLAN 2006 401k membership
Total participants, beginning-of-year	2006-09-01	152
Total number of active participants reported on line 7a of the Form 5500	2006-09-01	167
Total of all active and inactive participants	2006-09-01	167
2005: THE WILLIAMSPORT HOME LIFE AND AD&D PLAN 2005 401k membership
Total participants, beginning-of-year	2005-09-01	156
Total number of active participants reported on line 7a of the Form 5500	2005-09-01	152
Total of all active and inactive participants	2005-09-01	152
2004: THE WILLIAMSPORT HOME LIFE AND AD&D PLAN 2004 401k membership
Total participants, beginning-of-year	2004-09-01	156
Total number of active participants reported on line 7a of the Form 5500	2004-09-01	156
Total of all active and inactive participants	2004-09-01	156

Form 5500 Responses for THE WILLIAMSPORT HOME LIFE AND AD&D PLAN

2023: THE WILLIAMSPORT HOME LIFE AND AD&D PLAN 2023 form 5500 responses
2023-09-01	Type of plan entity	Single employer plan
2023-09-01	Plan funding arrangement – Insurance	Yes
2023-09-01	Plan benefit arrangement – Insurance	Yes
2022: THE WILLIAMSPORT HOME LIFE AND AD&D PLAN 2022 form 5500 responses
2022-09-01	Type of plan entity	Single employer plan
2022-09-01	Plan funding arrangement – Insurance	Yes
2022-09-01	Plan benefit arrangement – Insurance	Yes
2021: THE WILLIAMSPORT HOME LIFE AND AD&D PLAN 2021 form 5500 responses
2021-09-01	Type of plan entity	Single employer plan
2021-09-01	Plan funding arrangement – Insurance	Yes
2021-09-01	Plan benefit arrangement – Insurance	Yes
2020: THE WILLIAMSPORT HOME LIFE AND AD&D PLAN 2020 form 5500 responses
2020-09-01	Type of plan entity	Single employer plan
2020-09-01	Plan funding arrangement – Insurance	Yes
2020-09-01	Plan benefit arrangement – Insurance	Yes
2019: THE WILLIAMSPORT HOME LIFE AND AD&D PLAN 2019 form 5500 responses
2019-09-01	Type of plan entity	Single employer plan
2019-09-01	Plan funding arrangement – Insurance	Yes
2019-09-01	Plan benefit arrangement – Insurance	Yes
2018: THE WILLIAMSPORT HOME LIFE AND AD&D PLAN 2018 form 5500 responses
2018-09-01	Type of plan entity	Single employer plan
2018-09-01	Plan funding arrangement – Insurance	Yes
2018-09-01	Plan benefit arrangement – Insurance	Yes
2017: THE WILLIAMSPORT HOME LIFE AND AD&D PLAN 2017 form 5500 responses
2017-09-01	Type of plan entity	Single employer plan
2017-09-01	Plan funding arrangement – Insurance	Yes
2017-09-01	Plan benefit arrangement – Insurance	Yes
2016: THE WILLIAMSPORT HOME LIFE AND AD&D PLAN 2016 form 5500 responses
2016-09-01	Type of plan entity	Single employer plan
2016-09-01	Plan funding arrangement – Insurance	Yes
2016-09-01	Plan benefit arrangement – Insurance	Yes
2015: THE WILLIAMSPORT HOME LIFE AND AD&D PLAN 2015 form 5500 responses
2015-09-01	Type of plan entity	Single employer plan
2015-09-01	Plan funding arrangement – Insurance	Yes
2015-09-01	Plan benefit arrangement – Insurance	Yes
2014: THE WILLIAMSPORT HOME LIFE AND AD&D PLAN 2014 form 5500 responses
2014-09-01	Type of plan entity	Single employer plan
2014-09-01	Plan funding arrangement – Insurance	Yes
2014-09-01	Plan benefit arrangement – Insurance	Yes
2013: THE WILLIAMSPORT HOME LIFE AND AD&D PLAN 2013 form 5500 responses
2013-09-01	Type of plan entity	Single employer plan
2013-09-01	Plan funding arrangement – Insurance	Yes
2013-09-01	Plan benefit arrangement – Insurance	Yes
2012: THE WILLIAMSPORT HOME LIFE AND AD&D PLAN 2012 form 5500 responses
2012-09-01	Type of plan entity	Single employer plan
2012-09-01	Plan funding arrangement – Insurance	Yes
2012-09-01	Plan benefit arrangement – Insurance	Yes
2011: THE WILLIAMSPORT HOME LIFE AND AD&D PLAN 2011 form 5500 responses
2011-09-01	Type of plan entity	Single employer plan
2011-09-01	Plan funding arrangement – Insurance	Yes
2011-09-01	Plan benefit arrangement – Insurance	Yes
2009: THE WILLIAMSPORT HOME LIFE AND AD&D PLAN 2009 form 5500 responses
2009-09-01	Type of plan entity	Single employer plan
2009-09-01	This submission is the final filing	No
2009-09-01	Plan funding arrangement – Insurance	Yes
2009-09-01	Plan benefit arrangement – Insurance	Yes
2008: THE WILLIAMSPORT HOME LIFE AND AD&D PLAN 2008 form 5500 responses
2008-09-01	Type of plan entity	Single employer plan
2008-09-01	This submission is the final filing	No
2008-09-01	Plan funding arrangement – Insurance	Yes
2008-09-01	Plan benefit arrangement – Insurance	Yes
2007: THE WILLIAMSPORT HOME LIFE AND AD&D PLAN 2007 form 5500 responses
2007-09-01	Type of plan entity	Single employer plan
2007-09-01	This submission is the final filing	No
2007-09-01	Plan funding arrangement – Insurance	Yes
2007-09-01	Plan benefit arrangement – Insurance	Yes
2006: THE WILLIAMSPORT HOME LIFE AND AD&D PLAN 2006 form 5500 responses
2006-09-01	Type of plan entity	Single employer plan
2006-09-01	This submission is the final filing	No
2006-09-01	Plan funding arrangement – Insurance	Yes
2006-09-01	Plan benefit arrangement – Insurance	Yes
2005: THE WILLIAMSPORT HOME LIFE AND AD&D PLAN 2005 form 5500 responses
2005-09-01	Type of plan entity	Single employer plan
2005-09-01	This submission is the final filing	No
2005-09-01	Plan funding arrangement – Insurance	Yes
2005-09-01	Plan benefit arrangement – Insurance	Yes
2004: THE WILLIAMSPORT HOME LIFE AND AD&D PLAN 2004 form 5500 responses
2004-09-01	Type of plan entity	Single employer plan
2004-09-01	First time form 5500 has been submitted	Yes
2004-09-01	This submission is the final filing	No
2004-09-01	Plan funding arrangement – Insurance	Yes
2004-09-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 )

Policy contract number

G00616374

Policy instance

Insurance contract or identification number	G00616374
Number of Individuals Covered	294
Insurance policy start date	2023-09-01
Insurance policy end date	2024-08-31
Total amount of commissions paid to insurance broker	USD $181
Total amount of fees paid to insurance company	USD $0
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	AD&D
Welfare Benefit Premiums Paid to Carrier	USD $1,814
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 )

Policy contract number

G00616374

Policy instance

AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 )

Policy contract number

G00616374

Policy instance

AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 )

Policy contract number

G00616374

Policy instance

AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 )

Policy contract number

G00616374

Policy instance

AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 )

Policy contract number

G00616374

Policy instance

THE UNITED STATES LIFE INSURANCE COMPANY IN THE CITY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 70106 )

Policy contract number

G247968

Policy instance

AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 )

Policy contract number

G00616374

Policy instance

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Company Name:	THE WILLIAMSPORT HOME LIFE AND AD&D PLAN
Employer identification number (EIN):	240795507
NAIC Classification:	623000
NAIC Description:	Nursing and Residential Care Facilities