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FIVE STAR HOLDING CORP. GROUP HEALTH PLAN 401k Plan overview

Plan NameFIVE STAR HOLDING CORP. GROUP HEALTH PLAN
Plan identification number 501

FIVE STAR HOLDING CORP. GROUP HEALTH PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)

401k Sponsoring company profile

FIVE STAR HOLDING LLC has sponsored the creation of one or more 401k plans.

Company Name:FIVE STAR HOLDING LLC
Employer identification number (EIN):472544616
NAIC Classification:326100

Form 5500 Filing Information

Submission information for form 5500 for 401k plan FIVE STAR HOLDING CORP. GROUP HEALTH PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012020-03-01LOURDES DELIZ2020-10-27 LOURDES DELIZ2020-10-27
5012019-03-01LOURDES DELIZ2020-08-24 LOURDES DELIZ2020-08-24
5012018-03-01LOURDES DELIZ2019-09-18 LOURDES DELIZ2019-09-18
5012017-03-01
5012016-05-01
5012015-05-01

Plan Statistics for FIVE STAR HOLDING CORP. GROUP HEALTH PLAN

401k plan membership statisitcs for FIVE STAR HOLDING CORP. GROUP HEALTH PLAN

Measure Date Value
2020: FIVE STAR HOLDING CORP. GROUP HEALTH PLAN 2020 401k membership
Total participants, beginning-of-year2020-03-011,192
Total number of active participants reported on line 7a of the Form 55002020-03-010
Total of all active and inactive participants2020-03-010
2019: FIVE STAR HOLDING CORP. GROUP HEALTH PLAN 2019 401k membership
Total participants, beginning-of-year2019-03-01874
Total number of active participants reported on line 7a of the Form 55002019-03-011,192
Total of all active and inactive participants2019-03-011,192
2018: FIVE STAR HOLDING CORP. GROUP HEALTH PLAN 2018 401k membership
Total participants, beginning-of-year2018-03-01837
Total number of active participants reported on line 7a of the Form 55002018-03-01874
Total of all active and inactive participants2018-03-01874
2017: FIVE STAR HOLDING CORP. GROUP HEALTH PLAN 2017 401k membership
Total participants, beginning-of-year2017-03-01867
Total number of active participants reported on line 7a of the Form 55002017-03-01837
Total of all active and inactive participants2017-03-01837
2016: FIVE STAR HOLDING CORP. GROUP HEALTH PLAN 2016 401k membership
Total participants, beginning-of-year2016-05-01611
Total number of active participants reported on line 7a of the Form 55002016-05-01867
Total of all active and inactive participants2016-05-01867
2015: FIVE STAR HOLDING CORP. GROUP HEALTH PLAN 2015 401k membership
Total participants, beginning-of-year2015-05-01838
Total number of active participants reported on line 7a of the Form 55002015-05-01611
Total of all active and inactive participants2015-05-01611

Form 5500 Responses for FIVE STAR HOLDING CORP. GROUP HEALTH PLAN

2020: FIVE STAR HOLDING CORP. GROUP HEALTH 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)Yes
2020-03-01Plan is a collectively bargained planNo
2020-03-01Plan funding arrangement – InsuranceYes
2020-03-01Plan benefit arrangement – InsuranceYes
2019: FIVE STAR HOLDING CORP. GROUP HEALTH 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 benefit arrangement – InsuranceYes
2018: FIVE STAR HOLDING CORP. GROUP HEALTH 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 benefit arrangement – InsuranceYes
2017: FIVE STAR HOLDING CORP. GROUP HEALTH 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 benefit arrangement – InsuranceYes
2016: FIVE STAR HOLDING CORP. GROUP HEALTH PLAN 2016 form 5500 responses
2016-05-01Type of plan entitySingle employer plan
2016-05-01Submission has been amendedNo
2016-05-01This submission is the final filingNo
2016-05-01This return/report is a short plan year return/report (less than 12 months)Yes
2016-05-01Plan is a collectively bargained planNo
2016-05-01Plan funding arrangement – InsuranceYes
2016-05-01Plan benefit arrangement – InsuranceYes
2015: FIVE STAR HOLDING CORP. GROUP HEALTH PLAN 2015 form 5500 responses
2015-05-01Type of plan entitySingle employer plan
2015-05-01First time form 5500 has been submittedYes
2015-05-01Submission has been amendedNo
2015-05-01This submission is the final filingNo
2015-05-01This return/report is a short plan year return/report (less than 12 months)No
2015-05-01Plan is a collectively bargained planNo
2015-05-01Plan funding arrangement – InsuranceYes
2015-05-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number0701998
Policy instance 1
Insurance contract or identification number0701998
Number of Individuals Covered1174
Insurance policy start date2020-03-01
Insurance policy end date2020-03-31
Total amount of commissions paid to insurance brokerUSD $621
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $238,079
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $621
Insurance broker organization code?3
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number701998
Policy instance 1
Insurance contract or identification number701998
Number of Individuals Covered1192
Insurance policy start date2019-03-01
Insurance policy end date2020-02-29
Total amount of commissions paid to insurance brokerUSD $27,577
Total amount of fees paid to insurance companyUSD $10,199
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,473,169
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $27,577
Amount paid for insurance broker fees232
Additional information about fees paid to insurance brokerSERVICE FEE AGREEMENT
Insurance broker organization code?3
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number0701998
Policy instance 1
Insurance contract or identification number0701998
Number of Individuals Covered837
Insurance policy start date2017-03-01
Insurance policy end date2018-02-28
Total amount of commissions paid to insurance brokerUSD $4,764
Total amount of fees paid to insurance companyUSD $138,096
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,875,642
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,926
Amount paid for insurance broker fees121776
Additional information about fees paid to insurance brokerSERVICE FEE AGREEMENT
Insurance broker organization code?3
Insurance broker nameRICHARD J GREGORY, JR
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number0701998
Policy instance 1
Insurance contract or identification number0701998
Number of Individuals Covered975
Insurance policy start date2015-05-01
Insurance policy end date2016-04-30
Total amount of commissions paid to insurance brokerUSD $4,462
Total amount of fees paid to insurance companyUSD $111,939
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,031,689
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,462
Amount paid for insurance broker fees111911
Additional information about fees paid to insurance brokerSERVICE FEE AGREEMENT
Insurance broker organization code?3
Insurance broker nameINSURANCE ASSOCIATION OF THE

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