401k Plan data: EMPLOYEE WELFARE BENEFIT PLAN

EMPLOYEE WELFARE BENEFIT PLAN - HOSPICE OF WAKE CO 401k Plan overview

Plan Name	EMPLOYEE WELFARE BENEFIT PLAN - HOSPICE OF WAKE CO
Plan identification number	501

EMPLOYEE WELFARE BENEFIT PLAN - HOSPICE OF WAKE CO Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) Life insurance Dental Vision Temporary disability (accident and sickness) Long-term disability cover Other welfare benefit cover

401k Sponsoring company profile

HOSPICE OF WAKE COUNTY, INC. DBA TRANSITIONS LIFECARE has sponsored the creation of one or more 401k plans.

Company Name: HOSPICE OF WAKE COUNTY, INC. DBA TRANSITIONS LIFECARE

Employer identification number (EIN): 561228779

NAIC Classification: 813000
NAIC Description: Religious, Grantmaking, Civic, Professional, and Similar Organizations

Additional information about HOSPICE OF WAKE COUNTY, INC. DBA TRANSITIONS LIFECARE

Jurisdiction of Incorporation: North Carolina Secretary of State

Incorporation Date:

Company Identification Number: 0071376

More information about HOSPICE OF WAKE COUNTY, INC. DBA TRANSITIONS LIFECARE

Form 5500 Filing Information

Submission information for form 5500 for 401k plan EMPLOYEE WELFARE BENEFIT PLAN - HOSPICE OF WAKE CO

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2019-01-01
501 2018-01-01 TONI MESSLER 2019-09-16
501 2017-01-01
501 2016-01-01
501 2015-01-01
501 2014-01-01
501 2013-01-01
501 2012-01-01 TONI MESSLER
501 2011-01-01 TONI MESSLER
501 2009-01-01 TONI MESSLER

Plan Statistics for EMPLOYEE WELFARE BENEFIT PLAN - HOSPICE OF WAKE CO

401k plan membership statisitcs for EMPLOYEE WELFARE BENEFIT PLAN - HOSPICE OF WAKE CO

Measure Date Value
2019: EMPLOYEE WELFARE BENEFIT PLAN - HOSPICE OF WAKE CO 2019 401k membership
Total participants, beginning-of-year 2019-01-01 422
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 457
Number of retired or separated participants receiving benefits 2019-01-01 2
Number of other retired or separated participants entitled to future benefits 2019-01-01 0
Total of all active and inactive participants 2019-01-01 459
2018: EMPLOYEE WELFARE BENEFIT PLAN - HOSPICE OF WAKE CO 2018 401k membership
Total participants, beginning-of-year 2018-01-01 389
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 497
Total of all active and inactive participants 2018-01-01 497
2017: EMPLOYEE WELFARE BENEFIT PLAN - HOSPICE OF WAKE CO 2017 401k membership
Total participants, beginning-of-year 2017-01-01 360
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 389
Total of all active and inactive participants 2017-01-01 389
2016: EMPLOYEE WELFARE BENEFIT PLAN - HOSPICE OF WAKE CO 2016 401k membership
Total participants, beginning-of-year 2016-01-01 332
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 360
Total of all active and inactive participants 2016-01-01 360
2015: EMPLOYEE WELFARE BENEFIT PLAN - HOSPICE OF WAKE CO 2015 401k membership
Total participants, beginning-of-year 2015-01-01 269
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 332
Total of all active and inactive participants 2015-01-01 332
2014: EMPLOYEE WELFARE BENEFIT PLAN - HOSPICE OF WAKE CO 2014 401k membership
Total participants, beginning-of-year 2014-01-01 258
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 269
Total of all active and inactive participants 2014-01-01 269
2013: EMPLOYEE WELFARE BENEFIT PLAN - HOSPICE OF WAKE CO 2013 401k membership
Total participants, beginning-of-year 2013-01-01 244
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 258
Total of all active and inactive participants 2013-01-01 258
2012: EMPLOYEE WELFARE BENEFIT PLAN - HOSPICE OF WAKE CO 2012 401k membership
Total participants, beginning-of-year 2012-01-01 237
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 244
Total of all active and inactive participants 2012-01-01 244
2011: EMPLOYEE WELFARE BENEFIT PLAN - HOSPICE OF WAKE CO 2011 401k membership
Total participants, beginning-of-year 2011-01-01 224
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 237
Total of all active and inactive participants 2011-01-01 237
2009: EMPLOYEE WELFARE BENEFIT PLAN - HOSPICE OF WAKE CO 2009 401k membership
Total participants, beginning-of-year 2009-01-01 150
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 159
Total of all active and inactive participants 2009-01-01 159

Measure	Date	Value
2019: EMPLOYEE WELFARE BENEFIT PLAN - HOSPICE OF WAKE CO 2019 401k membership
Total participants, beginning-of-year	2019-01-01	422
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	457
Number of retired or separated participants receiving benefits	2019-01-01	2
Number of other retired or separated participants entitled to future benefits	2019-01-01	0
Total of all active and inactive participants	2019-01-01	459
2018: EMPLOYEE WELFARE BENEFIT PLAN - HOSPICE OF WAKE CO 2018 401k membership
Total participants, beginning-of-year	2018-01-01	389
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	497
Total of all active and inactive participants	2018-01-01	497
2017: EMPLOYEE WELFARE BENEFIT PLAN - HOSPICE OF WAKE CO 2017 401k membership
Total participants, beginning-of-year	2017-01-01	360
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	389
Total of all active and inactive participants	2017-01-01	389
2016: EMPLOYEE WELFARE BENEFIT PLAN - HOSPICE OF WAKE CO 2016 401k membership
Total participants, beginning-of-year	2016-01-01	332
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	360
Total of all active and inactive participants	2016-01-01	360
2015: EMPLOYEE WELFARE BENEFIT PLAN - HOSPICE OF WAKE CO 2015 401k membership
Total participants, beginning-of-year	2015-01-01	269
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	332
Total of all active and inactive participants	2015-01-01	332
2014: EMPLOYEE WELFARE BENEFIT PLAN - HOSPICE OF WAKE CO 2014 401k membership
Total participants, beginning-of-year	2014-01-01	258
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	269
Total of all active and inactive participants	2014-01-01	269
2013: EMPLOYEE WELFARE BENEFIT PLAN - HOSPICE OF WAKE CO 2013 401k membership
Total participants, beginning-of-year	2013-01-01	244
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	258
Total of all active and inactive participants	2013-01-01	258
2012: EMPLOYEE WELFARE BENEFIT PLAN - HOSPICE OF WAKE CO 2012 401k membership
Total participants, beginning-of-year	2012-01-01	237
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	244
Total of all active and inactive participants	2012-01-01	244
2011: EMPLOYEE WELFARE BENEFIT PLAN - HOSPICE OF WAKE CO 2011 401k membership
Total participants, beginning-of-year	2011-01-01	224
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	237
Total of all active and inactive participants	2011-01-01	237
2009: EMPLOYEE WELFARE BENEFIT PLAN - HOSPICE OF WAKE CO 2009 401k membership
Total participants, beginning-of-year	2009-01-01	150
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	159
Total of all active and inactive participants	2009-01-01	159

Form 5500 Responses for EMPLOYEE WELFARE BENEFIT PLAN - HOSPICE OF WAKE CO

2019: EMPLOYEE WELFARE BENEFIT PLAN - HOSPICE OF WAKE CO 2019 form 5500 responses
2019-01-01	Type of plan entity	Single employer plan
2019-01-01	Submission has been amended	No
2019-01-01	This submission is the final filing	No
2019-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2019-01-01	Plan is a collectively bargained plan	No
2019-01-01	Plan funding arrangement – Insurance	Yes
2019-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2019-01-01	Plan benefit arrangement – Insurance	Yes
2019-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2018: EMPLOYEE WELFARE BENEFIT PLAN - HOSPICE OF WAKE CO 2018 form 5500 responses
2018-01-01	Type of plan entity	Single employer plan
2018-01-01	Plan funding arrangement – Insurance	Yes
2018-01-01	Plan benefit arrangement – Insurance	Yes
2017: EMPLOYEE WELFARE BENEFIT PLAN - HOSPICE OF WAKE CO 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	Plan funding arrangement – Insurance	Yes
2017-01-01	Plan benefit arrangement – Insurance	Yes
2016: EMPLOYEE WELFARE BENEFIT PLAN - HOSPICE OF WAKE CO 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Plan funding arrangement – Insurance	Yes
2016-01-01	Plan benefit arrangement – Insurance	Yes
2015: EMPLOYEE WELFARE BENEFIT PLAN - HOSPICE OF WAKE CO 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Plan funding arrangement – Insurance	Yes
2015-01-01	Plan benefit arrangement – Insurance	Yes
2014: EMPLOYEE WELFARE BENEFIT PLAN - HOSPICE OF WAKE CO 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Plan funding arrangement – Insurance	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes
2013: EMPLOYEE WELFARE BENEFIT PLAN - HOSPICE OF WAKE CO 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Plan funding arrangement – Insurance	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2012: EMPLOYEE WELFARE BENEFIT PLAN - HOSPICE OF WAKE CO 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Plan funding arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2011: EMPLOYEE WELFARE BENEFIT PLAN - HOSPICE OF WAKE CO 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Plan funding arrangement – Insurance	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2009: EMPLOYEE WELFARE BENEFIT PLAN - HOSPICE OF WAKE CO 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	This submission is the final filing	No
2009-01-01	Plan funding arrangement – Insurance	Yes
2009-01-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

BUSINESS HEALTH SERVICES (National Association of Insurance Commissioners NAIC id number: 00000 )

Policy contract number

TRANSITIONS LIF

Policy instance

Insurance contract or identification number	TRANSITIONS LIF
Number of Individuals Covered	371
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Other welfare benefits provided	EAP
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Welfare Benefit Premiums Paid to Carrier	USD $11,409
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

PRE-PAID LEGAL SERVICES DBA LEGAL SHIELD (National Association of Insurance Commissioners NAIC id number: 00000 )

Policy contract number

139398

Policy instance

Insurance contract or identification number	139398
Number of Individuals Covered	7
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $186
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Other welfare benefits provided	LEGAL SERVICES PLAN MEMBERSHIPS
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Welfare Benefit Premiums Paid to Carrier	USD $1,515
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 )

Policy contract number

R7482

Policy instance

Insurance contract or identification number	R7482
Number of Individuals Covered	37
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $5,538
Total amount of fees paid to insurance company	USD $289
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Other welfare benefits provided	SUPPLEMENTAL BENEFITS
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Welfare Benefit Premiums Paid to Carrier	USD $29,302
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

NATIONAL GUARDIAN LIFE (National Association of Insurance Commissioners NAIC id number: 66583 )

Policy contract number

35657

Policy instance

Insurance contract or identification number	35657
Number of Individuals Covered	272
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	Yes
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Welfare Benefit Premiums Paid to Carrier	USD $32,894
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

DELTA DENTAL OF NORTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 54658 )

Policy contract number

1108

Policy instance

Insurance contract or identification number	1108
Number of Individuals Covered	711
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $28,720
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

BLUECROSS BLUESHIELD OF NORTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 54631 )

Policy contract number

079659

Policy instance

Insurance contract or identification number	079659
Number of Individuals Covered	590
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $62,236
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	Yes
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	Yes

HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )

Policy contract number

882553G

Policy instance

Insurance contract or identification number	882553G
Number of Individuals Covered	649
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $28,496
Total amount of fees paid to insurance company	USD $18,495
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Unemployment Insurance Welfare Benefit	No
Other welfare benefits provided	AD&D
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Welfare Benefit Premiums Paid to Carrier	USD $243,973
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

FLX964598

Policy instance

Insurance contract or identification number	FLX964598
Number of Individuals Covered	370
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $6,051
Total amount of fees paid to insurance company	USD $290
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $6,051
Insurance broker organization code?	3
Amount paid for insurance broker fees	290
Insurance broker name	C2 CENTRIC LLC

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

OK 966186

Policy instance

Insurance contract or identification number	OK 966186
Number of Individuals Covered	370
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $58
Total amount of fees paid to insurance company	USD $26
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $58
Insurance broker organization code?	3
Amount paid for insurance broker fees	26
Insurance broker name	C2 CENTRIC LLC

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

LK 751125

Policy instance

Insurance contract or identification number	LK 751125
Number of Individuals Covered	389
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $4,815
Total amount of fees paid to insurance company	USD $224
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $4,815
Insurance broker organization code?	3
Amount paid for insurance broker fees	224
Insurance broker name	C2 CENTRIC LLC

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

LK 963235

Policy instance

Insurance contract or identification number	LK 963235
Number of Individuals Covered	370
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $8,594
Total amount of fees paid to insurance company	USD $402
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $8,594
Insurance broker organization code?	3
Amount paid for insurance broker fees	402
Insurance broker name	C2 CENTRIC LLC

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

LK 963235

Policy instance

Insurance contract or identification number	LK 963235
Number of Individuals Covered	329
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $6,358
Total amount of fees paid to insurance company	USD $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $6,358
Insurance broker organization code?	3
Insurance broker name	JAMES A. SCOTT & SON, INC.

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

LK 751125

Policy instance

Insurance contract or identification number	LK 751125
Number of Individuals Covered	332
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $3,539
Total amount of fees paid to insurance company	USD $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $3,539
Insurance broker organization code?	3
Insurance broker name	JAMES A. SCOTT & SON, INC.

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

OK 966186

Policy instance

Insurance contract or identification number	OK 966186
Number of Individuals Covered	329
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $439
Total amount of fees paid to insurance company	USD $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $439
Insurance broker organization code?	3
Insurance broker name	JAMES A. SCOTT & SON, INC.

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

FLX964598

Policy instance

Insurance contract or identification number	FLX964598
Number of Individuals Covered	329
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $5,276
Total amount of fees paid to insurance company	USD $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $5,276
Insurance broker organization code?	3
Insurance broker name	JAMES A. SCOTT & SON, INC.

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

OK 966186

Policy instance

Insurance contract or identification number	OK 966186
Number of Individuals Covered	261
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $505
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $505
Insurance broker organization code?	3
Insurance broker name	JAMES A. SCOTT & SON, INC.

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

LK 963235

Policy instance

Insurance contract or identification number	LK 963235
Number of Individuals Covered	261
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $6,805
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $6,805
Insurance broker organization code?	3
Insurance broker name	JAMES A. SCOTT & SON, INC.

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

LK 751125

Policy instance

Insurance contract or identification number	LK 751125
Number of Individuals Covered	269
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $3,601
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $3,601
Insurance broker organization code?	3
Insurance broker name	JAMES A. SCOTT & SON, INC.

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

FLX964598

Policy instance

Insurance contract or identification number	FLX964598
Number of Individuals Covered	261
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $5,026
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $5,026
Insurance broker organization code?	3
Insurance broker name	JAMES A. SCOTT & SON, INC.

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

FLX964598

Policy instance

Insurance contract or identification number	FLX964598
Number of Individuals Covered	254
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $5,002
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $5,002
Insurance broker organization code?	3
Insurance broker name	JAMES A. SCOTT & SON, INC.

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

OK 966186

Policy instance

Insurance contract or identification number	OK 966186
Number of Individuals Covered	254
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $508
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $508
Insurance broker organization code?	3
Insurance broker name	JAMES A. SCOTT & SON, INC.

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

LK 751125

Policy instance

Insurance contract or identification number	LK 751125
Number of Individuals Covered	258
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $3,431
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $3,431
Insurance broker organization code?	3
Insurance broker name	JAMES A. SCOTT & SON, INC.

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

LK 963235

Policy instance

Insurance contract or identification number	LK 963235
Number of Individuals Covered	254
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $6,465
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $6,465
Insurance broker organization code?	3
Insurance broker name	JAMES A. SCOTT & SON, INC.

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

LK 963235

Policy instance

Insurance contract or identification number	LK 963235
Number of Individuals Covered	237
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $5,770
Total amount of fees paid to insurance company	USD $1,042
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $5,770
Amount paid for insurance broker fees	1042
Additional information about fees paid to insurance broker	OTHER ADVISORY FEES
Insurance broker organization code?	3
Insurance broker name	JAMES A. SCOTT & SON, INC.

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

LK 751125

Policy instance

Insurance contract or identification number	LK 751125
Number of Individuals Covered	244
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $2,920
Total amount of fees paid to insurance company	USD $435
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,920
Amount paid for insurance broker fees	435
Additional information about fees paid to insurance broker	OTHER ADVISORY FEES
Insurance broker organization code?	3
Insurance broker name	JAMES A. SCOTT & SON, INC.

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

OK 966186

Policy instance

Insurance contract or identification number	OK 966186
Number of Individuals Covered	237
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $473
Total amount of fees paid to insurance company	USD $83
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $473
Amount paid for insurance broker fees	83
Additional information about fees paid to insurance broker	OTHER ADVISORY FEES
Insurance broker organization code?	3
Insurance broker name	JAMES A. SCOTT & SON, INC.

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

FLX964598

Policy instance

Insurance contract or identification number	FLX964598
Number of Individuals Covered	237
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $4,644
Total amount of fees paid to insurance company	USD $657
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $4,644
Amount paid for insurance broker fees	657
Additional information about fees paid to insurance broker	OTHER ADVISORY FEES
Insurance broker organization code?	3
Insurance broker name	JAMES A. SCOTT & SON, INC.

METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )

Policy contract number

TM05570092

Policy instance

Insurance contract or identification number	TM05570092
Number of Individuals Covered	533
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $13,255
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

00086052879

Policy instance

Insurance contract or identification number	00086052879
Number of Individuals Covered	237
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $1,480
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

000860052881

Policy instance

Insurance contract or identification number	000860052881
Number of Individuals Covered	237
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $7,156
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

000860052882

Policy instance

Insurance contract or identification number	000860052882
Number of Individuals Covered	246
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $4,248
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

000860052882

Policy instance

Insurance contract or identification number	000860052882
Number of Individuals Covered	212
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $3,849
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $3,849
Insurance broker organization code?	3
Insurance broker name	JAMES A. SCOTT & SON, INC.

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

000400001000077

Policy instance

Insurance contract or identification number	000400001000077
Number of Individuals Covered	270
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $2,995
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,995
Insurance broker organization code?	3
Insurance broker name	JAMES A. SCOTT & SON, INC.

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

000860052879

Policy instance

Insurance contract or identification number	000860052879
Number of Individuals Covered	206
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $1,294
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,294
Insurance broker organization code?	3
Insurance broker name	JAMES A. SCOTT & SON, INC.

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

000860052881

Policy instance

Insurance contract or identification number	000860052881
Number of Individuals Covered	206
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $6,468
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $6,468
Insurance broker organization code?	3
Insurance broker name	JAMES A. SCOTT & SON, INC.

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Company Name:	HOSPICE OF WAKE COUNTY, INC. DBA TRANSITIONS LIFECARE
Employer identification number (EIN):	561228779
NAIC Classification:	813000
NAIC Description:	Religious, Grantmaking, Civic, Professional, and Similar Organizations

Jurisdiction of Incorporation:	North Carolina Secretary of State
Incorporation Date:
Company Identification Number:	0071376

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
501	2019-01-01
501	2018-01-01	TONI MESSLER	2019-09-16
501	2017-01-01
501	2016-01-01
501	2015-01-01
501	2014-01-01
501	2013-01-01
501	2012-01-01	TONI MESSLER
501	2011-01-01	TONI MESSLER
501	2009-01-01	TONI MESSLER