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TRI COUNTY HOME CARE LLC HEALTH AND WELFARE PLAN 401k Plan overview

Plan NameTRI COUNTY HOME CARE LLC HEALTH AND WELFARE PLAN
Plan identification number 501

TRI COUNTY HOME CARE LLC HEALTH AND WELFARE PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Vision
  • Other welfare benefit cover

401k Sponsoring company profile

TRI COUNTY HOME CARE LLC has sponsored the creation of one or more 401k plans.

Company Name:TRI COUNTY HOME CARE LLC
Employer identification number (EIN):364803901
NAIC Classification:621610
NAIC Description:Home Health Care Services

Form 5500 Filing Information

Submission information for form 5500 for 401k plan TRI COUNTY HOME CARE LLC HEALTH AND WELFARE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012020-03-01
5012020-03-01DAVID PALLASCHKE
5012019-03-01
5012019-03-01DAVID PALLASCHKE
5012018-03-01
5012018-03-01DAVID PALLASCHKE
5012017-03-01
5012017-03-01DAVID PALLASCHKE
5012016-03-01
5012016-03-01DAVID PALLASCHKE

Financial Data on TRI COUNTY HOME CARE LLC HEALTH AND WELFARE PLAN

Measure Date Value
2021 : TRI COUNTY HOME CARE LLC HEALTH AND WELFARE PLAN 2021 401k financial data
Transfers to/from the plan2021-02-28$0
Total plan liabilities at end of year2021-02-28$0
Total plan liabilities at beginning of year2021-02-28$0
Total income from all sources2021-02-28$6,250
Expenses. Total of all expenses incurred2021-02-28$6,250
Benefits paid (including direct rollovers)2021-02-28$6,250
Total plan assets at end of year2021-02-28$0
Total plan assets at beginning of year2021-02-28$0
Total contributions received or receivable from participants2021-02-28$3,125
Expenses. Other expenses not covered elsewhere2021-02-28$0
Contributions received from other sources (not participants or employers)2021-02-28$0
Other income received2021-02-28$0
Noncash contributions received2021-02-28$0
Net income (gross income less expenses)2021-02-28$0
Net plan assets at end of year (total assets less liabilities)2021-02-28$0
Net plan assets at beginning of year (total assets less liabilities)2021-02-28$0
Total contributions received or receivable from employer(s)2021-02-28$3,125
Value of certain deemed distributions of participant loans2021-02-28$0
Value of corrective distributions2021-02-28$0
Expenses. Administrative service providers (salaries,fees and commissions)2021-02-28$0
2020 : TRI COUNTY HOME CARE LLC HEALTH AND WELFARE PLAN 2020 401k financial data
Transfers to/from the plan2020-02-29$0
Total plan liabilities at end of year2020-02-29$0
Total plan liabilities at beginning of year2020-02-29$0
Total income from all sources2020-02-29$6,144
Expenses. Total of all expenses incurred2020-02-29$6,144
Benefits paid (including direct rollovers)2020-02-29$6,144
Total plan assets at end of year2020-02-29$0
Total plan assets at beginning of year2020-02-29$0
Total contributions received or receivable from participants2020-02-29$3,072
Expenses. Other expenses not covered elsewhere2020-02-29$0
Contributions received from other sources (not participants or employers)2020-02-29$0
Other income received2020-02-29$0
Noncash contributions received2020-02-29$0
Net income (gross income less expenses)2020-02-29$0
Net plan assets at end of year (total assets less liabilities)2020-02-29$0
Net plan assets at beginning of year (total assets less liabilities)2020-02-29$0
Total contributions received or receivable from employer(s)2020-02-29$3,072
Value of certain deemed distributions of participant loans2020-02-29$0
Value of corrective distributions2020-02-29$0
Expenses. Administrative service providers (salaries,fees and commissions)2020-02-29$0
2019 : TRI COUNTY HOME CARE LLC HEALTH AND WELFARE PLAN 2019 401k financial data
Transfers to/from the plan2019-02-28$0
Total plan liabilities at end of year2019-02-28$0
Total plan liabilities at beginning of year2019-02-28$0
Total income from all sources2019-02-28$28,476
Expenses. Total of all expenses incurred2019-02-28$28,476
Benefits paid (including direct rollovers)2019-02-28$28,476
Total plan assets at end of year2019-02-28$0
Total plan assets at beginning of year2019-02-28$0
Total contributions received or receivable from participants2019-02-28$14,238
Expenses. Other expenses not covered elsewhere2019-02-28$0
Contributions received from other sources (not participants or employers)2019-02-28$0
Other income received2019-02-28$0
Noncash contributions received2019-02-28$0
Net income (gross income less expenses)2019-02-28$0
Net plan assets at end of year (total assets less liabilities)2019-02-28$0
Net plan assets at beginning of year (total assets less liabilities)2019-02-28$0
Total contributions received or receivable from employer(s)2019-02-28$14,238
Value of certain deemed distributions of participant loans2019-02-28$0
Value of corrective distributions2019-02-28$0
Expenses. Administrative service providers (salaries,fees and commissions)2019-02-28$0
2018 : TRI COUNTY HOME CARE LLC HEALTH AND WELFARE PLAN 2018 401k financial data
Transfers to/from the plan2018-02-28$0
Total plan liabilities at end of year2018-02-28$0
Total plan liabilities at beginning of year2018-02-28$0
Total income from all sources2018-02-28$32,644
Expenses. Total of all expenses incurred2018-02-28$32,644
Benefits paid (including direct rollovers)2018-02-28$32,644
Total plan assets at end of year2018-02-28$0
Total plan assets at beginning of year2018-02-28$0
Total contributions received or receivable from participants2018-02-28$16,322
Expenses. Other expenses not covered elsewhere2018-02-28$0
Contributions received from other sources (not participants or employers)2018-02-28$0
Other income received2018-02-28$0
Noncash contributions received2018-02-28$0
Net income (gross income less expenses)2018-02-28$0
Net plan assets at end of year (total assets less liabilities)2018-02-28$0
Net plan assets at beginning of year (total assets less liabilities)2018-02-28$0
Total contributions received or receivable from employer(s)2018-02-28$16,322
Value of certain deemed distributions of participant loans2018-02-28$0
Value of corrective distributions2018-02-28$0
Expenses. Administrative service providers (salaries,fees and commissions)2018-02-28$0
2017 : TRI COUNTY HOME CARE LLC HEALTH AND WELFARE PLAN 2017 401k financial data
Transfers to/from the plan2017-02-28$0
Total plan liabilities at end of year2017-02-28$0
Total plan liabilities at beginning of year2017-02-28$0
Total income from all sources2017-02-28$31,798
Expenses. Total of all expenses incurred2017-02-28$31,798
Benefits paid (including direct rollovers)2017-02-28$31,798
Total plan assets at end of year2017-02-28$0
Total plan assets at beginning of year2017-02-28$0
Total contributions received or receivable from participants2017-02-28$15,899
Expenses. Other expenses not covered elsewhere2017-02-28$0
Contributions received from other sources (not participants or employers)2017-02-28$0
Other income received2017-02-28$0
Noncash contributions received2017-02-28$0
Net income (gross income less expenses)2017-02-28$0
Net plan assets at end of year (total assets less liabilities)2017-02-28$0
Net plan assets at beginning of year (total assets less liabilities)2017-02-28$0
Total contributions received or receivable from employer(s)2017-02-28$15,899
Value of certain deemed distributions of participant loans2017-02-28$0
Value of corrective distributions2017-02-28$0
Expenses. Administrative service providers (salaries,fees and commissions)2017-02-28$0

Form 5500 Responses for TRI COUNTY HOME CARE LLC HEALTH AND WELFARE PLAN

2020: TRI COUNTY HOME CARE LLC HEALTH AND WELFARE PLAN 2020 form 5500 responses
2020-03-01Type of plan entitySingle employer plan
2020-03-01Submission has been amendedNo
2020-03-01This submission is the final filingYes
2020-03-01This return/report is a short plan year return/report (less than 12 months)No
2020-03-01Plan is a collectively bargained planNo
2020-03-01Plan funding arrangement – InsuranceYes
2020-03-01Plan funding arrangement – TrustYes
2020-03-01Plan benefit arrangement – InsuranceYes
2019: TRI COUNTY HOME CARE LLC HEALTH AND WELFARE PLAN 2019 form 5500 responses
2019-03-01Type of plan entitySingle employer plan
2019-03-01Submission has been amendedNo
2019-03-01This submission is the final filingNo
2019-03-01This return/report is a short plan year return/report (less than 12 months)No
2019-03-01Plan is a collectively bargained planNo
2019-03-01Plan funding arrangement – InsuranceYes
2019-03-01Plan funding arrangement – TrustYes
2019-03-01Plan benefit arrangement – InsuranceYes
2018: TRI COUNTY HOME CARE LLC HEALTH AND WELFARE PLAN 2018 form 5500 responses
2018-03-01Type of plan entitySingle employer plan
2018-03-01Submission has been amendedNo
2018-03-01This submission is the final filingNo
2018-03-01This return/report is a short plan year return/report (less than 12 months)No
2018-03-01Plan is a collectively bargained planNo
2018-03-01Plan funding arrangement – InsuranceYes
2018-03-01Plan funding arrangement – TrustYes
2018-03-01Plan benefit arrangement – InsuranceYes
2017: TRI COUNTY HOME CARE LLC HEALTH AND WELFARE PLAN 2017 form 5500 responses
2017-03-01Type of plan entitySingle employer plan
2017-03-01Submission has been amendedNo
2017-03-01This submission is the final filingNo
2017-03-01This return/report is a short plan year return/report (less than 12 months)No
2017-03-01Plan is a collectively bargained planNo
2017-03-01Plan funding arrangement – InsuranceYes
2017-03-01Plan funding arrangement – TrustYes
2017-03-01Plan benefit arrangement – InsuranceYes
2016: TRI COUNTY HOME CARE LLC HEALTH AND WELFARE PLAN 2016 form 5500 responses
2016-03-01Type of plan entitySingle employer plan
2016-03-01First time form 5500 has been submittedYes
2016-03-01Submission has been amendedNo
2016-03-01This submission is the final filingNo
2016-03-01This return/report is a short plan year return/report (less than 12 months)No
2016-03-01Plan is a collectively bargained planNo
2016-03-01Plan funding arrangement – InsuranceYes
2016-03-01Plan funding arrangement – TrustYes
2016-03-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number0806334
Policy instance 1
Insurance contract or identification number0806334
Number of Individuals Covered374
Insurance policy start date2020-03-01
Insurance policy end date2021-02-28
Total amount of commissions paid to insurance brokerUSD $16,244
Total amount of fees paid to insurance companyUSD $0
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 BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $1,983,086
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number803237G/890889G
Policy instance 2
Insurance contract or identification number803237G/890889G
Number of Individuals Covered414
Insurance policy start date2020-03-01
Insurance policy end date2021-02-28
Total amount of commissions paid to insurance brokerUSD $11,835
Total amount of fees paid to insurance companyUSD $38
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 providedAD&D, ACCIDENT
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $80,578
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number0806334
Policy instance 1
Insurance contract or identification number0806334
Number of Individuals Covered320
Insurance policy start date2019-03-01
Insurance policy end date2020-02-29
Total amount of commissions paid to insurance brokerUSD $17,073
Total amount of fees paid to insurance companyUSD $0
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 BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $1,734,000
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number803237G
Policy instance 2
Insurance contract or identification number803237G
Number of Individuals Covered320
Insurance policy start date2019-03-01
Insurance policy end date2020-02-29
Total amount of commissions paid to insurance brokerUSD $8,594
Total amount of fees paid to insurance companyUSD $403
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 providedAD&D
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $52,918
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number0806334
Policy instance 1
Insurance contract or identification number0806334
Number of Individuals Covered300
Insurance policy start date2018-03-01
Insurance policy end date2019-02-28
Total amount of commissions paid to insurance brokerUSD $22,636
Total amount of fees paid to insurance companyUSD $0
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 BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedAD&D
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $1,706,609
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number0806334
Policy instance 1
Insurance contract or identification number0806334
Number of Individuals Covered268
Insurance policy start date2017-03-01
Insurance policy end date2018-02-28
Total amount of commissions paid to insurance brokerUSD $22,538
Total amount of fees paid to insurance companyUSD $1,525
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 BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedAD&D
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $1,861,589
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number0806334
Policy instance 1
Insurance contract or identification number0806334
Number of Individuals Covered358
Insurance policy start date2016-03-01
Insurance policy end date2017-02-28
Total amount of commissions paid to insurance brokerUSD $23,051
Total amount of fees paid to insurance companyUSD $978
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 BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedAD&D
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $2,010,722
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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