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FRIENDS OF FAITH RETIREMENT HOMES INC LIFE INSURANCE PLAN 401k Plan overview

Plan NameFRIENDS OF FAITH RETIREMENT HOMES INC LIFE INSURANCE PLAN
Plan identification number 501

FRIENDS OF FAITH RETIREMENT HOMES INC LIFE INSURANCE PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Temporary disability (accident and sickness)

401k Sponsoring company profile

FRIENDS OF FAITH RETIREMENT HOME, INC. has sponsored the creation of one or more 401k plans.

Company Name:FRIENDS OF FAITH RETIREMENT HOME, INC.
Employer identification number (EIN):510245745
NAIC Classification:623000
NAIC Description: Nursing and Residential Care Facilities

Form 5500 Filing Information

Submission information for form 5500 for 401k plan FRIENDS OF FAITH RETIREMENT HOMES INC LIFE INSURANCE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012021-05-01
5012019-05-01
5012018-05-01
5012017-05-01LISA GATES
5012017-05-01
5012016-05-01LISA GATES
5012015-05-01LISA GATES
5012014-05-01LISA GATES
5012013-05-01LISA GATES
5012012-05-01LISA GATES
5012011-05-01LISA GATES
5012010-05-01LISA GATES
5012009-05-01LISA GATES

Plan Statistics for FRIENDS OF FAITH RETIREMENT HOMES INC LIFE INSURANCE PLAN

401k plan membership statisitcs for FRIENDS OF FAITH RETIREMENT HOMES INC LIFE INSURANCE PLAN

Measure Date Value
2021: FRIENDS OF FAITH RETIREMENT HOMES INC LIFE INSURANCE PLAN 2021 401k membership
Total participants, beginning-of-year2021-05-01201
Total number of active participants reported on line 7a of the Form 55002021-05-01205
Number of retired or separated participants receiving benefits2021-05-010
Number of other retired or separated participants entitled to future benefits2021-05-010
Total of all active and inactive participants2021-05-01205
2019: FRIENDS OF FAITH RETIREMENT HOMES INC LIFE INSURANCE PLAN 2019 401k membership
Total participants, beginning-of-year2019-05-01185
Total number of active participants reported on line 7a of the Form 55002019-05-01186
Number of retired or separated participants receiving benefits2019-05-010
Number of other retired or separated participants entitled to future benefits2019-05-010
Total of all active and inactive participants2019-05-01186
2018: FRIENDS OF FAITH RETIREMENT HOMES INC LIFE INSURANCE PLAN 2018 401k membership
Total participants, beginning-of-year2018-05-01192
Total number of active participants reported on line 7a of the Form 55002018-05-01185
Number of retired or separated participants receiving benefits2018-05-010
Number of other retired or separated participants entitled to future benefits2018-05-010
Total of all active and inactive participants2018-05-01185
2017: FRIENDS OF FAITH RETIREMENT HOMES INC LIFE INSURANCE PLAN 2017 401k membership
Total participants, beginning-of-year2017-05-01181
Total number of active participants reported on line 7a of the Form 55002017-05-01192
Number of retired or separated participants receiving benefits2017-05-010
Number of other retired or separated participants entitled to future benefits2017-05-010
Total of all active and inactive participants2017-05-01192
2016: FRIENDS OF FAITH RETIREMENT HOMES INC LIFE INSURANCE PLAN 2016 401k membership
Total participants, beginning-of-year2016-05-01174
Total number of active participants reported on line 7a of the Form 55002016-05-01181
Number of retired or separated participants receiving benefits2016-05-010
Number of other retired or separated participants entitled to future benefits2016-05-010
Total of all active and inactive participants2016-05-01181
2015: FRIENDS OF FAITH RETIREMENT HOMES INC LIFE INSURANCE PLAN 2015 401k membership
Total participants, beginning-of-year2015-05-01176
Total number of active participants reported on line 7a of the Form 55002015-05-01174
Number of retired or separated participants receiving benefits2015-05-010
Number of other retired or separated participants entitled to future benefits2015-05-010
Total of all active and inactive participants2015-05-01174
2014: FRIENDS OF FAITH RETIREMENT HOMES INC LIFE INSURANCE PLAN 2014 401k membership
Total participants, beginning-of-year2014-05-01175
Total number of active participants reported on line 7a of the Form 55002014-05-01176
Number of retired or separated participants receiving benefits2014-05-010
Number of other retired or separated participants entitled to future benefits2014-05-010
Total of all active and inactive participants2014-05-01176
2013: FRIENDS OF FAITH RETIREMENT HOMES INC LIFE INSURANCE PLAN 2013 401k membership
Total participants, beginning-of-year2013-05-01156
Total number of active participants reported on line 7a of the Form 55002013-05-01175
Total of all active and inactive participants2013-05-01175
2012: FRIENDS OF FAITH RETIREMENT HOMES INC LIFE INSURANCE PLAN 2012 401k membership
Total participants, beginning-of-year2012-05-01151
Total number of active participants reported on line 7a of the Form 55002012-05-01156
Total of all active and inactive participants2012-05-01156
2011: FRIENDS OF FAITH RETIREMENT HOMES INC LIFE INSURANCE PLAN 2011 401k membership
Total participants, beginning-of-year2011-05-01157
Total number of active participants reported on line 7a of the Form 55002011-05-01151
Total of all active and inactive participants2011-05-01151
Total participants2011-05-01151
2010: FRIENDS OF FAITH RETIREMENT HOMES INC LIFE INSURANCE PLAN 2010 401k membership
Total participants, beginning-of-year2010-05-01159
Total number of active participants reported on line 7a of the Form 55002010-05-01157
Total of all active and inactive participants2010-05-01157
Total participants2010-05-01157
2009: FRIENDS OF FAITH RETIREMENT HOMES INC LIFE INSURANCE PLAN 2009 401k membership
Total participants, beginning-of-year2009-05-01143
Total number of active participants reported on line 7a of the Form 55002009-05-01159
Total of all active and inactive participants2009-05-01159
Total participants2009-05-01159

Form 5500 Responses for FRIENDS OF FAITH RETIREMENT HOMES INC LIFE INSURANCE PLAN

2021: FRIENDS OF FAITH RETIREMENT HOMES INC LIFE INSURANCE PLAN 2021 form 5500 responses
2021-05-01Type of plan entitySingle employer plan
2021-05-01Plan funding arrangement – InsuranceYes
2021-05-01Plan benefit arrangement – InsuranceYes
2019: FRIENDS OF FAITH RETIREMENT HOMES INC LIFE INSURANCE PLAN 2019 form 5500 responses
2019-05-01Type of plan entitySingle employer plan
2019-05-01Plan funding arrangement – InsuranceYes
2019-05-01Plan benefit arrangement – InsuranceYes
2018: FRIENDS OF FAITH RETIREMENT HOMES INC LIFE INSURANCE PLAN 2018 form 5500 responses
2018-05-01Type of plan entitySingle employer plan
2018-05-01Plan funding arrangement – InsuranceYes
2018-05-01Plan benefit arrangement – InsuranceYes
2017: FRIENDS OF FAITH RETIREMENT HOMES INC LIFE INSURANCE PLAN 2017 form 5500 responses
2017-05-01Type of plan entitySingle employer plan
2017-05-01Submission has been amendedYes
2017-05-01Plan funding arrangement – InsuranceYes
2017-05-01Plan benefit arrangement – InsuranceYes
2016: FRIENDS OF FAITH RETIREMENT HOMES INC LIFE INSURANCE PLAN 2016 form 5500 responses
2016-05-01Type of plan entitySingle employer plan
2016-05-01Plan funding arrangement – InsuranceYes
2016-05-01Plan benefit arrangement – InsuranceYes
2015: FRIENDS OF FAITH RETIREMENT HOMES INC LIFE INSURANCE PLAN 2015 form 5500 responses
2015-05-01Type of plan entitySingle employer plan
2015-05-01Plan funding arrangement – InsuranceYes
2015-05-01Plan benefit arrangement – InsuranceYes
2014: FRIENDS OF FAITH RETIREMENT HOMES INC LIFE INSURANCE PLAN 2014 form 5500 responses
2014-05-01Type of plan entitySingle employer plan
2014-05-01Plan funding arrangement – InsuranceYes
2014-05-01Plan benefit arrangement – InsuranceYes
2013: FRIENDS OF FAITH RETIREMENT HOMES INC LIFE INSURANCE PLAN 2013 form 5500 responses
2013-05-01Type of plan entitySingle employer plan
2013-05-01Plan funding arrangement – InsuranceYes
2013-05-01Plan benefit arrangement – InsuranceYes
2012: FRIENDS OF FAITH RETIREMENT HOMES INC LIFE INSURANCE PLAN 2012 form 5500 responses
2012-05-01Type of plan entitySingle employer plan
2012-05-01Submission has been amendedYes
2012-05-01Plan funding arrangement – InsuranceYes
2012-05-01Plan benefit arrangement – InsuranceYes
2011: FRIENDS OF FAITH RETIREMENT HOMES INC LIFE INSURANCE PLAN 2011 form 5500 responses
2011-05-01Type of plan entitySingle employer plan
2011-05-01Plan funding arrangement – InsuranceYes
2011-05-01Plan benefit arrangement – InsuranceYes
2010: FRIENDS OF FAITH RETIREMENT HOMES INC LIFE INSURANCE PLAN 2010 form 5500 responses
2010-05-01Type of plan entitySingle employer plan
2010-05-01Plan funding arrangement – InsuranceYes
2010-05-01Plan benefit arrangement – InsuranceYes
2009: FRIENDS OF FAITH RETIREMENT HOMES INC LIFE INSURANCE PLAN 2009 form 5500 responses
2009-05-01Type of plan entitySingle employer plan
2009-05-01Plan funding arrangement – InsuranceYes
2009-05-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number923931
Policy instance 3
Insurance contract or identification number923931
Number of Individuals Covered205
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $7,271
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $87,217
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,271
Insurance broker organization code?3
WELLMARK HEALTH PLAN OF IOWA (National Association of Insurance Commissioners NAIC id number: 95531 )
Policy contract number00045691
Policy instance 2
Insurance contract or identification number00045691
Number of Individuals Covered42
Insurance policy start date2021-05-01
Insurance policy end date2022-04-30
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $488,783
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
WELLMARK BLUE CROSS BLUE SHIELD OF SOUTH DAKOTA (National Association of Insurance Commissioners NAIC id number: 88848 )
Policy contract number00045691
Policy instance 1
Insurance contract or identification number00045691
Number of Individuals Covered51
Insurance policy start date2021-05-01
Insurance policy end date2022-04-30
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $527,760
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 number923931
Policy instance 3
Insurance contract or identification number923931
Number of Individuals Covered186
Insurance policy start date2019-05-01
Insurance policy end date2020-04-30
Total amount of commissions paid to insurance brokerUSD $7,365
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $89,790
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,365
Insurance broker organization code?3
WELLMARK HEALTH PLAN OF IOWA (National Association of Insurance Commissioners NAIC id number: 95531 )
Policy contract number00045691
Policy instance 2
Insurance contract or identification number00045691
Number of Individuals Covered61
Insurance policy start date2019-05-01
Insurance policy end date2020-04-30
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $593,128
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
WELLMARK BLUE CROSS BLUE SHIELD OF SOUTH DAKOTA (National Association of Insurance Commissioners NAIC id number: 88848 )
Policy contract number00045691
Policy instance 1
Insurance contract or identification number00045691
Number of Individuals Covered41
Insurance policy start date2019-05-01
Insurance policy end date2020-04-30
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $486,409
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 )
Policy contract number3000000/5459732
Policy instance 4
Insurance contract or identification number3000000/5459732
Number of Individuals Covered78
Insurance policy start date2018-05-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $1,435
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $28,712
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,435
Insurance broker organization code?3
WELLMARK BLUE CROSS BLUE SHIELD OF SOUTH DAKOTA (National Association of Insurance Commissioners NAIC id number: 88848 )
Policy contract number00045691
Policy instance 5
Insurance contract or identification number00045691
Number of Individuals Covered44
Insurance policy start date2018-05-01
Insurance policy end date2019-04-30
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $404,621
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
WELLMARK HEALTH PLAN OF IOWA (National Association of Insurance Commissioners NAIC id number: 95531 )
Policy contract number00045691
Policy instance 6
Insurance contract or identification number00045691
Number of Individuals Covered57
Insurance policy start date2018-05-01
Insurance policy end date2019-04-30
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $509,632
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 number923931
Policy instance 7
Insurance contract or identification number923931
Number of Individuals Covered189
Insurance policy start date2019-01-01
Insurance policy end date2019-04-30
Total amount of commissions paid to insurance brokerUSD $3,167
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $27,794
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,167
Insurance broker organization code?3
UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 )
Policy contract number5453107
Policy instance 3
Insurance contract or identification number5453107
Number of Individuals Covered35
Insurance policy start date2018-05-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $1,127
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $7,529
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,127
Insurance broker organization code?3
UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 )
Policy contract number5453107
Policy instance 2
Insurance contract or identification number5453107
Number of Individuals Covered42
Insurance policy start date2018-05-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $2,222
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $14,812
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,222
Insurance broker organization code?3
UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 )
Policy contract number5453107
Policy instance 1
Insurance contract or identification number5453107
Number of Individuals Covered185
Insurance policy start date2018-05-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $511
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $5,114
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $511
Insurance broker organization code?3
WELLMARK HEALTH PLAN OF IOWA (National Association of Insurance Commissioners NAIC id number: 95531 )
Policy contract number00045691
Policy instance 6
Insurance contract or identification number00045691
Number of Individuals Covered55
Insurance policy start date2017-05-01
Insurance policy end date2018-04-30
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $486,875
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
WELLMARK BLUE CROSS BLUE SHIELD OF SOUTH DAKOTA (National Association of Insurance Commissioners NAIC id number: 88848 )
Policy contract number00045691
Policy instance 5
Insurance contract or identification number00045691
Number of Individuals Covered40
Insurance policy start date2017-05-01
Insurance policy end date2018-04-30
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $342,797
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 )
Policy contract number3000000/5459732
Policy instance 4
Insurance contract or identification number3000000/5459732
Number of Individuals Covered85
Insurance policy start date2017-05-01
Insurance policy end date2018-04-30
Total amount of commissions paid to insurance brokerUSD $2,191
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $43,805
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 )
Policy contract number5453107
Policy instance 3
Insurance contract or identification number5453107
Number of Individuals Covered40
Insurance policy start date2017-05-01
Insurance policy end date2018-04-30
Total amount of commissions paid to insurance brokerUSD $1,618
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $10,767
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 )
Policy contract number5453107
Policy instance 2
Insurance contract or identification number5453107
Number of Individuals Covered47
Insurance policy start date2017-05-01
Insurance policy end date2018-04-30
Total amount of commissions paid to insurance brokerUSD $3,029
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $20,202
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 )
Policy contract number5453107
Policy instance 1
Insurance contract or identification number5453107
Number of Individuals Covered192
Insurance policy start date2017-05-01
Insurance policy end date2018-04-30
Total amount of commissions paid to insurance brokerUSD $736
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $7,357
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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