401k Plan data: ASSOCIATES IN PEDIATRIC THERAPY, LLC HEALTH AND WELFARE BENEFIT PLAN plan

ASSOCIATES IN PEDIATRIC THERAPY, LLC HEALTH AND WELFARE BENEFIT PLAN 401k Plan overview

Plan Name	ASSOCIATES IN PEDIATRIC THERAPY, LLC HEALTH AND WELFARE BENEFIT PLAN
Plan identification number	501

ASSOCIATES IN PEDIATRIC THERAPY, LLC HEALTH AND WELFARE BENEFIT PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) Life insurance Dental Vision Temporary disability (accident and sickness) Long-term disability cover Other welfare benefit cover

401k Sponsoring company profile

ASSOCIATES IN PEDIATRIC THERAPY LLC has sponsored the creation of one or more 401k plans.

Company Name: ASSOCIATES IN PEDIATRIC THERAPY LLC

Employer identification number (EIN): 331195715

NAIC Classification: 621340
NAIC Description: Offices of Physical, Occupational and Speech Therapists, and Audiologists

Form 5500 Filing Information

Submission information for form 5500 for 401k plan ASSOCIATES IN PEDIATRIC THERAPY, LLC HEALTH AND WELFARE BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2023-01-01 ASHLEY JONES 2024-05-15
501 2022-01-01 ASHLEY JONES 2023-07-13

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
501	2023-01-01	ASHLEY JONES	2024-05-15
501	2022-01-01	ASHLEY JONES	2023-07-13

Plan Statistics for ASSOCIATES IN PEDIATRIC THERAPY, LLC HEALTH AND WELFARE BENEFIT PLAN

401k plan membership statisitcs for ASSOCIATES IN PEDIATRIC THERAPY, LLC HEALTH AND WELFARE BENEFIT PLAN

Measure Date Value
2023: ASSOCIATES IN PEDIATRIC THERAPY, LLC HEALTH AND WELFARE BENEFIT PLAN 2023 401k membership
Total participants, beginning-of-year 2023-01-01 207
Total number of active participants reported on line 7a of the Form 5500 2023-01-01 231
Total of all active and inactive participants 2023-01-01 231
2022: ASSOCIATES IN PEDIATRIC THERAPY, LLC HEALTH AND WELFARE BENEFIT PLAN 2022 401k membership
Total participants, beginning-of-year 2022-01-01 113
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 204
Number of retired or separated participants receiving benefits 2022-01-01 3
Total of all active and inactive participants 2022-01-01 207

Measure	Date	Value
2023: ASSOCIATES IN PEDIATRIC THERAPY, LLC HEALTH AND WELFARE BENEFIT PLAN 2023 401k membership
Total participants, beginning-of-year	2023-01-01	207
Total number of active participants reported on line 7a of the Form 5500	2023-01-01	231
Total of all active and inactive participants	2023-01-01	231
2022: ASSOCIATES IN PEDIATRIC THERAPY, LLC HEALTH AND WELFARE BENEFIT PLAN 2022 401k membership
Total participants, beginning-of-year	2022-01-01	113
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	204
Number of retired or separated participants receiving benefits	2022-01-01	3
Total of all active and inactive participants	2022-01-01	207

Form 5500 Responses for ASSOCIATES IN PEDIATRIC THERAPY, LLC HEALTH AND WELFARE BENEFIT PLAN

2023: ASSOCIATES IN PEDIATRIC THERAPY, LLC HEALTH AND WELFARE BENEFIT PLAN 2023 form 5500 responses
2023-01-01	Type of plan entity	Single employer plan
2023-01-01	Plan funding arrangement – Insurance	Yes
2023-01-01	Plan benefit arrangement – Insurance	Yes
2022: ASSOCIATES IN PEDIATRIC THERAPY, LLC HEALTH AND WELFARE BENEFIT PLAN 2022 form 5500 responses
2022-01-01	Type of plan entity	Single employer plan
2022-01-01	First time form 5500 has been submitted	Yes
2022-01-01	Plan funding arrangement – Insurance	Yes
2022-01-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )

Policy contract number

GUDE0C35K

Policy instance

Insurance contract or identification number	GUDE0C35K
Number of Individuals Covered	50
Insurance policy start date	2023-01-01
Insurance policy end date	2023-12-31
Total amount of commissions paid to insurance broker	USD $347
Total amount of fees paid to insurance company	USD $117
Other welfare benefits provided	VOL CRITICAL ILLNESS
Welfare Benefit Premiums Paid to Carrier	USD $2,312
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )

Policy contract number

GUDH0C35K

Policy instance

Insurance contract or identification number	GUDH0C35K
Number of Individuals Covered	44
Insurance policy start date	2023-01-01
Insurance policy end date	2023-12-31
Total amount of commissions paid to insurance broker	USD $1,678
Total amount of fees paid to insurance company	USD $326
Other welfare benefits provided	VOL ACCIDENT
Welfare Benefit Premiums Paid to Carrier	USD $8,392
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )

Policy contract number

GVTL0C35K

Policy instance

Insurance contract or identification number	GVTL0C35K
Number of Individuals Covered	89
Insurance policy start date	2023-01-01
Insurance policy end date	2023-12-31
Total amount of commissions paid to insurance broker	USD $1,094
Total amount of fees paid to insurance company	USD $643
Other welfare benefits provided	VOL LIFE, VOL AD&D
Welfare Benefit Premiums Paid to Carrier	USD $7,292
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )

Policy contract number

GUPR0C35K

Policy instance

Insurance contract or identification number	GUPR0C35K
Number of Individuals Covered	64
Insurance policy start date	2023-01-01
Insurance policy end date	2023-12-31
Total amount of commissions paid to insurance broker	USD $3,930
Total amount of fees paid to insurance company	USD $1,031
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $26,201
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )

Policy contract number

GUC0C35K

Policy instance

Insurance contract or identification number	GUC0C35K
Number of Individuals Covered	88
Insurance policy start date	2023-01-01
Insurance policy end date	2023-12-31
Total amount of commissions paid to insurance broker	USD $12,178
Total amount of fees paid to insurance company	USD $4,595
Temporary Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $93,679
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )

Policy contract number

GLUG0C35K

Policy instance

Insurance contract or identification number	GLUG0C35K
Number of Individuals Covered	231
Insurance policy start date	2023-01-01
Insurance policy end date	2023-12-31
Total amount of commissions paid to insurance broker	USD $864
Total amount of fees paid to insurance company	USD $849
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	AD&D
Welfare Benefit Premiums Paid to Carrier	USD $5,762
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

COMPBENEFITS (National Association of Insurance Commissioners NAIC id number: 54739 )

Policy contract number

809366

Policy instance

Insurance contract or identification number	809366
Number of Individuals Covered	141
Insurance policy start date	2023-01-01
Insurance policy end date	2023-12-31
Total amount of commissions paid to insurance broker	USD $5,567
Total amount of fees paid to insurance company	USD $493
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $51,542
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

HUMANA HEALTH PLAN, INC. (National Association of Insurance Commissioners NAIC id number: 95885 )

Policy contract number

809366

Policy instance

Insurance contract or identification number	809366
Number of Individuals Covered	138
Insurance policy start date	2023-01-01
Insurance policy end date	2023-12-31
Total amount of commissions paid to insurance broker	USD $24,756
Total amount of fees paid to insurance company	USD $9,059
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $626,620
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )

Policy contract number

GUDE0C35K

Policy instance

Insurance contract or identification number	GUDE0C35K
Number of Individuals Covered	38
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $171
Other welfare benefits provided	CRITICAL ILLNESS
Welfare Benefit Premiums Paid to Carrier	USD $1,710
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )

Policy contract number

GUDH0C35K

Policy instance

Insurance contract or identification number	GUDH0C35K
Number of Individuals Covered	31
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $486
Other welfare benefits provided	ACCIDENT
Welfare Benefit Premiums Paid to Carrier	USD $4,862
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )

Policy contract number

GVTL0C35K

Policy instance

Insurance contract or identification number	GVTL0C35K
Number of Individuals Covered	76
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $883
Other welfare benefits provided	VOLUNTARY LIFE, VOLUNTARY AD&D
Welfare Benefit Premiums Paid to Carrier	USD $5,886
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )

Policy contract number

GUPR0C35K

Policy instance

Insurance contract or identification number	GUPR0C35K
Number of Individuals Covered	53
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $3,259
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $21,727
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )

Policy contract number

GUC0C35K

Policy instance

Insurance contract or identification number	GUC0C35K
Number of Individuals Covered	60
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $9,056
Temporary Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $60,371
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )

Policy contract number

GLUG0C35K

Policy instance

Insurance contract or identification number	GLUG0C35K
Number of Individuals Covered	204
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $712
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	AD&D
Welfare Benefit Premiums Paid to Carrier	USD $4,747
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

DELTA DENTAL OF KENTUCKY (National Association of Insurance Commissioners NAIC id number: 54674 )

Policy contract number

0713360

Policy instance

Insurance contract or identification number	0713360
Number of Individuals Covered	185
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $3,662
Dental Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

HUMANA HEALTH PLAN, INC. (National Association of Insurance Commissioners NAIC id number: 95885 )

Policy contract number

809366

Policy instance

Insurance contract or identification number	809366
Number of Individuals Covered	125
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $21,219
Total amount of fees paid to insurance company	USD $2,958
Health Insurance Welfare Benefit	Yes
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $537,494
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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Company Name:	ASSOCIATES IN PEDIATRIC THERAPY LLC
Employer identification number (EIN):	331195715
NAIC Classification:	621340
NAIC Description:	Offices of Physical, Occupational and Speech Therapists, and Audiologists