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MEDICAL INSURANCE PLAN 401k Plan overview

Plan NameMEDICAL INSURANCE PLAN
Plan identification number 511

MEDICAL INSURANCE PLAN Benefits

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

401k Sponsoring company profile

MORAVIAN HOME, INC. DBA SALEMTOWNE has sponsored the creation of one or more 401k plans.

Company Name:MORAVIAN HOME, INC. DBA SALEMTOWNE
Employer identification number (EIN):560963926
NAIC Classification:623000
NAIC Description: Nursing and Residential Care Facilities

Form 5500 Filing Information

Submission information for form 5500 for 401k plan MEDICAL INSURANCE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5112020-09-01ALLISON E. VESSELS2022-03-09
5112020-09-01ALLISON E. VESSELS2023-01-18
5112019-09-01BRIAN TUCKMANTEL2021-06-02
5112018-09-01KATHY WILSON2020-06-05
5112017-09-01KATHY WILSON2019-06-13
5112016-09-01
5112015-09-01
5112014-09-01
5112013-09-01
5112012-09-01CAROLYN TWISDALE, CFO
5112011-09-01CAROLYN TWISDALE
5112009-09-01CAROLYN TWISDALE

Plan Statistics for MEDICAL INSURANCE PLAN

401k plan membership statisitcs for MEDICAL INSURANCE PLAN

Measure Date Value
2020: MEDICAL INSURANCE PLAN 2020 401k membership
Total participants, beginning-of-year2020-09-01187
Total number of active participants reported on line 7a of the Form 55002020-09-01172
Total of all active and inactive participants2020-09-01172
Number of retired or separated participants receiving benefits2020-09-010
Number of other retired or separated participants entitled to future benefits2020-09-010
Number of employers contributing to the scheme2020-09-010
2019: MEDICAL INSURANCE PLAN 2019 401k membership
Total participants, beginning-of-year2019-09-01195
Total number of active participants reported on line 7a of the Form 55002019-09-01187
Total of all active and inactive participants2019-09-01187
2018: MEDICAL INSURANCE PLAN 2018 401k membership
Total participants, beginning-of-year2018-09-01206
Total number of active participants reported on line 7a of the Form 55002018-09-01195
Total of all active and inactive participants2018-09-01195
2017: MEDICAL INSURANCE PLAN 2017 401k membership
Total participants, beginning-of-year2017-09-01195
Total number of active participants reported on line 7a of the Form 55002017-09-01206
Total of all active and inactive participants2017-09-01206
2016: MEDICAL INSURANCE PLAN 2016 401k membership
Total participants, beginning-of-year2016-09-01188
Total number of active participants reported on line 7a of the Form 55002016-09-01195
Total of all active and inactive participants2016-09-01195
2015: MEDICAL INSURANCE PLAN 2015 401k membership
Total participants, beginning-of-year2015-09-01180
Total number of active participants reported on line 7a of the Form 55002015-09-01188
Total of all active and inactive participants2015-09-01188
Total participants2015-09-01188
2014: MEDICAL INSURANCE PLAN 2014 401k membership
Total participants, beginning-of-year2014-09-01173
Total number of active participants reported on line 7a of the Form 55002014-09-01180
Total of all active and inactive participants2014-09-01180
2013: MEDICAL INSURANCE PLAN 2013 401k membership
Total participants, beginning-of-year2013-09-01173
Total number of active participants reported on line 7a of the Form 55002013-09-01173
Total of all active and inactive participants2013-09-01173
2012: MEDICAL INSURANCE PLAN 2012 401k membership
Total participants, beginning-of-year2012-09-01175
Total number of active participants reported on line 7a of the Form 55002012-09-01173
Total of all active and inactive participants2012-09-01173
2011: MEDICAL INSURANCE PLAN 2011 401k membership
Total participants, beginning-of-year2011-09-01174
Total number of active participants reported on line 7a of the Form 55002011-09-01175
Total of all active and inactive participants2011-09-01175
2009: MEDICAL INSURANCE PLAN 2009 401k membership
Total participants, beginning-of-year2009-09-01180
Total number of active participants reported on line 7a of the Form 55002009-09-01176
Total of all active and inactive participants2009-09-01176

Form 5500 Responses for MEDICAL INSURANCE PLAN

2020: MEDICAL INSURANCE PLAN 2020 form 5500 responses
2020-09-01Type of plan entitySingle employer plan
2020-09-01Submission has been amendedYes
2020-09-01This submission is the final filingYes
2020-09-01Plan funding arrangement – InsuranceYes
2020-09-01Plan benefit arrangement – InsuranceYes
2019: MEDICAL INSURANCE PLAN 2019 form 5500 responses
2019-09-01Type of plan entitySingle employer plan
2019-09-01Plan funding arrangement – InsuranceYes
2019-09-01Plan benefit arrangement – InsuranceYes
2018: MEDICAL INSURANCE PLAN 2018 form 5500 responses
2018-09-01Type of plan entitySingle employer plan
2018-09-01Plan funding arrangement – InsuranceYes
2018-09-01Plan benefit arrangement – InsuranceYes
2017: MEDICAL INSURANCE PLAN 2017 form 5500 responses
2017-09-01Type of plan entitySingle employer plan
2017-09-01Plan funding arrangement – InsuranceYes
2017-09-01Plan benefit arrangement – InsuranceYes
2016: MEDICAL INSURANCE PLAN 2016 form 5500 responses
2016-09-01Type of plan entitySingle employer plan
2016-09-01Plan funding arrangement – InsuranceYes
2016-09-01Plan benefit arrangement – InsuranceYes
2015: MEDICAL INSURANCE PLAN 2015 form 5500 responses
2015-09-01Type of plan entitySingle employer plan
2015-09-01Plan funding arrangement – InsuranceYes
2015-09-01Plan benefit arrangement – InsuranceYes
2014: MEDICAL INSURANCE PLAN 2014 form 5500 responses
2014-09-01Type of plan entitySingle employer plan
2014-09-01Plan funding arrangement – InsuranceYes
2014-09-01Plan benefit arrangement – InsuranceYes
2013: MEDICAL INSURANCE PLAN 2013 form 5500 responses
2013-09-01Type of plan entitySingle employer plan
2013-09-01Plan funding arrangement – InsuranceYes
2013-09-01Plan benefit arrangement – InsuranceYes
2012: MEDICAL INSURANCE PLAN 2012 form 5500 responses
2012-09-01Type of plan entitySingle employer plan
2012-09-01Plan funding arrangement – InsuranceYes
2012-09-01Plan benefit arrangement – InsuranceYes
2011: MEDICAL INSURANCE PLAN 2011 form 5500 responses
2011-09-01Type of plan entitySingle employer plan
2011-09-01Plan funding arrangement – InsuranceYes
2011-09-01Plan benefit arrangement – InsuranceYes
2009: MEDICAL INSURANCE PLAN 2009 form 5500 responses
2009-09-01Type of plan entitySingle employer plan
2009-09-01This submission is the final filingNo
2009-09-01Plan funding arrangement – InsuranceYes
2009-09-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number00630294
Policy instance 1
Insurance contract or identification number00630294
Number of Individuals Covered172
Insurance policy start date2020-09-01
Insurance policy end date2021-08-31
Total amount of commissions paid to insurance brokerUSD $5,000
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,000
Insurance broker organization code?3
Welfare Benefit Premiums Paid to CarrierUSD $349,954
Amount paid for insurance broker fees0
BLUECROSS BLUESHIELD OF NORTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 54631 )
Policy contract number042420
Policy instance 1
Insurance contract or identification number042420
Number of Individuals Covered187
Insurance policy start date2019-09-01
Insurance policy end date2020-08-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Insurance broker organization code?3
BLUECROSS BLUESHIELD OF NORTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 54631 )
Policy contract number042420
Policy instance 1
Insurance contract or identification number042420
Number of Individuals Covered195
Insurance policy start date2018-09-01
Insurance policy end date2019-08-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Insurance broker organization code?3
BLUECROSS BLUESHIELD OF NORTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 54631 )
Policy contract number042420
Policy instance 1
Insurance contract or identification number042420
Number of Individuals Covered206
Insurance policy start date2017-09-01
Insurance policy end date2018-08-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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