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| Plan Name | LUTHER MANOR SECTION 105 HEALTH REIMBURSEMENT ARRANGEMENT PLAN |
| Plan identification number | 517 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | UNITED LUTHERAN PROGRAM FOR THE AGING, INC. DBA LUTHER MANOR |
| Employer identification number (EIN): | 390981434 |
| 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 |
|---|---|---|---|---|---|
| 517 | 2022-01-01 | DAVID WOLFE | 2023-07-21 |
| Measure | Date | Value |
|---|---|---|
| 2022: LUTHER MANOR SECTION 105 HEALTH REIMBURSEMENT ARRANGEMENT PLAN 2022 401k membership | ||
| Total participants, beginning-of-year | 2022-01-01 | 107 |
| Total number of active participants reported on line 7a of the Form 5500 | 2022-01-01 | 89 |
| Number of retired or separated participants receiving benefits | 2022-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2022-01-01 | 0 |
| Total of all active and inactive participants | 2022-01-01 | 89 |
| 2022: LUTHER MANOR SECTION 105 HEALTH REIMBURSEMENT ARRANGEMENT 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 – General assets of the sponsor | Yes |
| 2022-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
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