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LONG TERM DISABILITY, LIFE, AD & D 401k Plan overview

Plan NameLONG TERM DISABILITY, LIFE, AD & D
Plan identification number 505

LONG TERM DISABILITY, LIFE, AD & D Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Life insurance
  • Long-term disability cover

401k Sponsoring company profile

ORCHARD PLACE has sponsored the creation of one or more 401k plans.

Company Name:ORCHARD PLACE
Employer identification number (EIN):421463736
NAIC Classification:623000
NAIC Description: Nursing and Residential Care Facilities

Additional information about ORCHARD PLACE

Jurisdiction of Incorporation: Iowa Secretary of State Business Entities
Incorporation Date: 1996-07-22
Company Identification Number: 197681
Legal Registered Office Address: 2116 GRAND AVE

DES MOINES
United States of America (USA)
50312

More information about ORCHARD PLACE

Form 5500 Filing Information

Submission information for form 5500 for 401k plan LONG TERM DISABILITY, LIFE, AD & D

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5052022-07-01VALERIE SALTSGAVER2023-11-02 VALERIE SALTSGAVER2023-11-02
5052021-07-01VALERIE SALTSGAVER2022-11-10 VALERIE SALTSGAVER2022-11-10
5052020-07-01VALERIE SALTSGAVER2021-10-25 VALERIE SALTSGAVER2021-10-25
5052019-07-01VALERIE SALTSGAVER2020-10-09 VALERIE SALTSGAVER2020-10-09
5052018-07-01VALERIE SALTSGAVER2019-09-13 VALERIE SALTSGAVER2019-09-13
5052017-07-01
5052016-07-01
5052015-07-01
5052014-07-01
5052013-07-01
5052012-07-01VALERIE SALTSGAVER
5052011-07-01VALERIE SALTSGAVER
5052010-07-01VALERIE SALTSGAVER
5052009-07-01VALERIE SALTSGAVER

Plan Statistics for LONG TERM DISABILITY, LIFE, AD & D

401k plan membership statisitcs for LONG TERM DISABILITY, LIFE, AD & D

Measure Date Value
2022: LONG TERM DISABILITY, LIFE, AD & D 2022 401k membership
Total participants, beginning-of-year2022-07-01281
Total number of active participants reported on line 7a of the Form 55002022-07-01261
Total of all active and inactive participants2022-07-01261
2021: LONG TERM DISABILITY, LIFE, AD & D 2021 401k membership
Total participants, beginning-of-year2021-07-01272
Total number of active participants reported on line 7a of the Form 55002021-07-01281
Total of all active and inactive participants2021-07-01281
2020: LONG TERM DISABILITY, LIFE, AD & D 2020 401k membership
Total participants, beginning-of-year2020-07-01298
Total number of active participants reported on line 7a of the Form 55002020-07-01272
Total of all active and inactive participants2020-07-01272
2019: LONG TERM DISABILITY, LIFE, AD & D 2019 401k membership
Total participants, beginning-of-year2019-07-01296
Total number of active participants reported on line 7a of the Form 55002019-07-01298
Total of all active and inactive participants2019-07-01298
2018: LONG TERM DISABILITY, LIFE, AD & D 2018 401k membership
Total participants, beginning-of-year2018-07-01280
Total number of active participants reported on line 7a of the Form 55002018-07-01296
Total of all active and inactive participants2018-07-01296
2017: LONG TERM DISABILITY, LIFE, AD & D 2017 401k membership
Total participants, beginning-of-year2017-07-01287
Total number of active participants reported on line 7a of the Form 55002017-07-01280
Total of all active and inactive participants2017-07-01280
2016: LONG TERM DISABILITY, LIFE, AD & D 2016 401k membership
Total participants, beginning-of-year2016-07-01334
Total number of active participants reported on line 7a of the Form 55002016-07-01287
Total of all active and inactive participants2016-07-01287
2015: LONG TERM DISABILITY, LIFE, AD & D 2015 401k membership
Total participants, beginning-of-year2015-07-01331
Total number of active participants reported on line 7a of the Form 55002015-07-01334
Total of all active and inactive participants2015-07-01334
2014: LONG TERM DISABILITY, LIFE, AD & D 2014 401k membership
Total participants, beginning-of-year2014-07-01332
Total number of active participants reported on line 7a of the Form 55002014-07-01331
Total of all active and inactive participants2014-07-01331
2013: LONG TERM DISABILITY, LIFE, AD & D 2013 401k membership
Total participants, beginning-of-year2013-07-01286
Total number of active participants reported on line 7a of the Form 55002013-07-01332
Total of all active and inactive participants2013-07-01332
2012: LONG TERM DISABILITY, LIFE, AD & D 2012 401k membership
Total participants, beginning-of-year2012-07-01275
Total number of active participants reported on line 7a of the Form 55002012-07-01286
Total of all active and inactive participants2012-07-01286
2011: LONG TERM DISABILITY, LIFE, AD & D 2011 401k membership
Total participants, beginning-of-year2011-07-01271
Total number of active participants reported on line 7a of the Form 55002011-07-01275
Total of all active and inactive participants2011-07-01275
2010: LONG TERM DISABILITY, LIFE, AD & D 2010 401k membership
Total participants, beginning-of-year2010-07-01280
Total number of active participants reported on line 7a of the Form 55002010-07-01271
Total of all active and inactive participants2010-07-01271
2009: LONG TERM DISABILITY, LIFE, AD & D 2009 401k membership
Total participants, beginning-of-year2009-07-01273
Total number of active participants reported on line 7a of the Form 55002009-07-01280
Total of all active and inactive participants2009-07-01280

Form 5500 Responses for LONG TERM DISABILITY, LIFE, AD & D

2022: LONG TERM DISABILITY, LIFE, AD & D 2022 form 5500 responses
2022-07-01Type of plan entitySingle employer plan
2022-07-01Plan funding arrangement – InsuranceYes
2022-07-01Plan benefit arrangement – InsuranceYes
2021: LONG TERM DISABILITY, LIFE, AD & D 2021 form 5500 responses
2021-07-01Type of plan entitySingle employer plan
2021-07-01Plan funding arrangement – InsuranceYes
2021-07-01Plan benefit arrangement – InsuranceYes
2020: LONG TERM DISABILITY, LIFE, AD & D 2020 form 5500 responses
2020-07-01Type of plan entitySingle employer plan
2020-07-01Plan funding arrangement – InsuranceYes
2020-07-01Plan benefit arrangement – InsuranceYes
2019: LONG TERM DISABILITY, LIFE, AD & D 2019 form 5500 responses
2019-07-01Type of plan entitySingle employer plan
2019-07-01Plan funding arrangement – InsuranceYes
2019-07-01Plan benefit arrangement – InsuranceYes
2018: LONG TERM DISABILITY, LIFE, AD & D 2018 form 5500 responses
2018-07-01Type of plan entitySingle employer plan
2018-07-01Plan funding arrangement – InsuranceYes
2018-07-01Plan benefit arrangement – InsuranceYes
2017: LONG TERM DISABILITY, LIFE, AD & D 2017 form 5500 responses
2017-07-01Type of plan entitySingle employer plan
2017-07-01Plan funding arrangement – InsuranceYes
2017-07-01Plan benefit arrangement – InsuranceYes
2016: LONG TERM DISABILITY, LIFE, AD & D 2016 form 5500 responses
2016-07-01Type of plan entitySingle employer plan
2016-07-01Plan funding arrangement – InsuranceYes
2016-07-01Plan benefit arrangement – InsuranceYes
2015: LONG TERM DISABILITY, LIFE, AD & D 2015 form 5500 responses
2015-07-01Type of plan entitySingle employer plan
2015-07-01Plan funding arrangement – InsuranceYes
2015-07-01Plan benefit arrangement – InsuranceYes
2014: LONG TERM DISABILITY, LIFE, AD & D 2014 form 5500 responses
2014-07-01Type of plan entitySingle employer plan
2014-07-01Plan funding arrangement – InsuranceYes
2014-07-01Plan benefit arrangement – InsuranceYes
2013: LONG TERM DISABILITY, LIFE, AD & D 2013 form 5500 responses
2013-07-01Type of plan entitySingle employer plan
2013-07-01Plan funding arrangement – InsuranceYes
2013-07-01Plan benefit arrangement – InsuranceYes
2012: LONG TERM DISABILITY, LIFE, AD & D 2012 form 5500 responses
2012-07-01Type of plan entitySingle employer plan
2012-07-01Plan funding arrangement – InsuranceYes
2012-07-01Plan benefit arrangement – InsuranceYes
2011: LONG TERM DISABILITY, LIFE, AD & D 2011 form 5500 responses
2011-07-01Type of plan entitySingle employer plan
2011-07-01Plan funding arrangement – InsuranceYes
2011-07-01Plan benefit arrangement – InsuranceYes
2010: LONG TERM DISABILITY, LIFE, AD & D 2010 form 5500 responses
2010-07-01Type of plan entitySingle employer plan
2010-07-01Plan funding arrangement – InsuranceYes
2010-07-01Plan benefit arrangement – InsuranceYes
2009: LONG TERM DISABILITY, LIFE, AD & D 2009 form 5500 responses
2009-07-01Type of plan entitySingle employer plan
2009-07-01This submission is the final filingNo
2009-07-01Plan funding arrangement – InsuranceYes
2009-07-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number887898G
Policy instance 1
Insurance contract or identification number887898G
Number of Individuals Covered261
Insurance policy start date2022-07-01
Insurance policy end date2023-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $56,526
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees0
Insurance broker organization code?3
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number887898G
Policy instance 1
Insurance contract or identification number887898G
Number of Individuals Covered281
Insurance policy start date2021-07-01
Insurance policy end date2022-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $55,038
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees0
Insurance broker organization code?3
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number887898G
Policy instance 1
Insurance contract or identification number887898G
Number of Individuals Covered272
Insurance policy start date2020-07-01
Insurance policy end date2021-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $63,374
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees0
Insurance broker organization code?3
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number887898G
Policy instance 1
Insurance contract or identification number887898G
Number of Individuals Covered298
Insurance policy start date2019-07-01
Insurance policy end date2020-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $4,122
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $64,943
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees4122
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number008812
Policy instance 1
Insurance contract or identification number008812
Number of Individuals Covered280
Insurance policy start date2017-07-01
Insurance policy end date2018-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $70,895
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number008812
Policy instance 1
Insurance contract or identification number008812
Number of Individuals Covered334
Insurance policy start date2015-07-01
Insurance policy end date2016-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $79,602
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number008812
Policy instance 1
Insurance contract or identification number008812
Number of Individuals Covered331
Insurance policy start date2014-07-01
Insurance policy end date2015-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $83,247
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number008812
Policy instance 1
Insurance contract or identification number008812
Number of Individuals Covered332
Insurance policy start date2013-07-01
Insurance policy end date2014-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $79,159
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number008812
Policy instance 1
Insurance contract or identification number008812
Number of Individuals Covered286
Insurance policy start date2012-07-01
Insurance policy end date2013-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $67,043
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number008812
Policy instance 1
Insurance contract or identification number008812
Number of Individuals Covered275
Insurance policy start date2011-07-01
Insurance policy end date2012-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $67,382
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number008812
Policy instance 1
Insurance contract or identification number008812
Number of Individuals Covered271
Insurance policy start date2010-07-01
Insurance policy end date2011-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $65,736
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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