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| Plan Name | GROUP LIFE PLAN FOR THE VILLAGE AT LUTHER SQUARE |
| Plan identification number | 501 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | LIFE NORTHWESTERN PENNSYLVANIA, LLC |
| Employer identification number (EIN): | 250990591 |
| 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 | 2015-01-01 | GENEVIEVE PUTNAM | GENEVIEVE PUTNAM | 2016-03-11 | |
| 501 | 2015-01-01 | GENEVIEVE PUTNAM | |||
| 501 | 2014-01-01 | GENEVIEVE PUTNAM | GENEVIEVE PUTNAM | 2015-06-30 |
| Measure | Date | Value |
|---|---|---|
| 2015: GROUP LIFE PLAN FOR THE VILLAGE AT LUTHER SQUARE 2015 401k membership | ||
| Total participants, beginning-of-year | 2015-01-01 | 119 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-01-01 | 130 |
| Total of all active and inactive participants | 2015-01-01 | 130 |
| 2014: GROUP LIFE PLAN FOR THE VILLAGE AT LUTHER SQUARE 2014 401k membership | ||
| Total participants, beginning-of-year | 2014-01-01 | 114 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-01-01 | 119 |
| Total of all active and inactive participants | 2014-01-01 | 119 |
| 2015: GROUP LIFE PLAN FOR THE VILLAGE AT LUTHER SQUARE 2015 form 5500 responses | ||
|---|---|---|
| 2015-01-01 | Type of plan entity | Single employer plan |
| 2015-01-01 | Submission has been amended | No |
| 2015-01-01 | This submission is the final filing | No |
| 2015-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2015-01-01 | Plan is a collectively bargained plan | No |
| 2015-01-01 | Plan funding arrangement – Insurance | Yes |
| 2015-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2014: GROUP LIFE PLAN FOR THE VILLAGE AT LUTHER SQUARE 2014 form 5500 responses | ||
| 2014-01-01 | Type of plan entity | Single employer plan |
| 2014-01-01 | First time form 5500 has been submitted | Yes |
| 2014-01-01 | Submission has been amended | No |
| 2014-01-01 | This submission is the final filing | No |
| 2014-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2014-01-01 | Plan is a collectively bargained plan | No |
| 2014-01-01 | Plan funding arrangement – Insurance | Yes |
| 2014-01-01 | Plan benefit arrangement – Insurance | Yes |
| SECURITY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68721 ) | |
| Policy contract number | 39374 |
| Policy instance | 1 |
| SECURITY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68721 ) | |
| Policy contract number | 39374 |
| Policy instance | 1 |
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