| Plan Name | MEDICAL PLAN |
| Plan identification number | 505 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
|
| Company Name: | TRUSTCARE HEALTH LLC DBA TRUSTCARE HEALTH |
| Employer identification number (EIN): | 465704074 |
| NAIC Classification: | 541990 |
| NAIC Description: | All Other Professional, Scientific, and Technical Services |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 505 | 2023-09-01 | TRUMAN ABBE | 2024-12-18 | ||
| 505 | 2022-09-01 | TRUMAN ABBE | 2024-01-09 |
| Measure | Date | Value |
|---|---|---|
| 2023: MEDICAL PLAN 2023 401k membership | ||
| Total participants, beginning-of-year | 2023-09-01 | 117 |
| Total number of active participants reported on line 7a of the Form 5500 | 2023-09-01 | 95 |
| Number of retired or separated participants receiving benefits | 2023-09-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2023-09-01 | 0 |
| Total of all active and inactive participants | 2023-09-01 | 95 |
| Number of employers contributing to the scheme | 2023-09-01 | 0 |
| 2022: MEDICAL PLAN 2022 401k membership | ||
| Total participants, beginning-of-year | 2022-09-01 | 100 |
| Total number of active participants reported on line 7a of the Form 5500 | 2022-09-01 | 72 |
| Number of retired or separated participants receiving benefits | 2022-09-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2022-09-01 | 0 |
| Total of all active and inactive participants | 2022-09-01 | 72 |
| Number of employers contributing to the scheme | 2022-09-01 | 0 |
| 2023: MEDICAL PLAN 2023 form 5500 responses | ||
|---|---|---|
| 2023-09-01 | Type of plan entity | Single employer plan |
| 2023-09-01 | Plan funding arrangement – Insurance | Yes |
| 2023-09-01 | Plan benefit arrangement – Insurance | Yes |
| 2022: MEDICAL PLAN 2022 form 5500 responses | ||
| 2022-09-01 | Type of plan entity | Single employer plan |
| 2022-09-01 | First time form 5500 has been submitted | Yes |
| 2022-09-01 | Plan funding arrangement – Insurance | Yes |
| 2022-09-01 | Plan benefit arrangement – Insurance | Yes |
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) | |||||||||||||||||||
| Policy contract number | 928535 | ||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||
| |||||||||||||||||||
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) | |||||||||||||||||||
| Policy contract number | 928535 | ||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||