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FAMILY SERVICE OF THE PIEDMONT, INC. GROUP HEALTH PLAN 401k Plan overview

Plan NameFAMILY SERVICE OF THE PIEDMONT, INC. GROUP HEALTH PLAN
Plan identification number 501

FAMILY SERVICE OF THE PIEDMONT, INC. GROUP HEALTH PLAN Benefits

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

401k Sponsoring company profile

FAMILY SERVICE OF THE PIEDMONT, INC. has sponsored the creation of one or more 401k plans.

Company Name:FAMILY SERVICE OF THE PIEDMONT, INC.
Employer identification number (EIN):562061741
NAIC Classification:624100
NAIC Description: Individual and Family Services

Form 5500 Filing Information

Submission information for form 5500 for 401k plan FAMILY SERVICE OF THE PIEDMONT, INC. GROUP HEALTH PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012024-04-01BECKY HUNT
5012023-04-01
5012023-04-01BECKY HUNT
5012022-04-01
5012022-04-01BECKY HUNT
5012021-04-01
5012021-04-01BECKY HUNT
5012020-04-01

Plan Statistics for FAMILY SERVICE OF THE PIEDMONT, INC. GROUP HEALTH PLAN

401k plan membership statisitcs for FAMILY SERVICE OF THE PIEDMONT, INC. GROUP HEALTH PLAN

Measure Date Value
2023: FAMILY SERVICE OF THE PIEDMONT, INC. GROUP HEALTH PLAN 2023 401k membership
Total participants, beginning-of-year2023-04-01107
Total number of active participants reported on line 7a of the Form 55002023-04-01103
Number of retired or separated participants receiving benefits2023-04-010
Number of other retired or separated participants entitled to future benefits2023-04-010
Total of all active and inactive participants2023-04-01103
2022: FAMILY SERVICE OF THE PIEDMONT, INC. GROUP HEALTH PLAN 2022 401k membership
Total participants, beginning-of-year2022-04-01104
Total number of active participants reported on line 7a of the Form 55002022-04-01110
Number of retired or separated participants receiving benefits2022-04-010
Number of other retired or separated participants entitled to future benefits2022-04-010
Total of all active and inactive participants2022-04-01110
2021: FAMILY SERVICE OF THE PIEDMONT, INC. GROUP HEALTH PLAN 2021 401k membership
Total participants, beginning-of-year2021-04-01110
Total number of active participants reported on line 7a of the Form 55002021-04-0196
Number of retired or separated participants receiving benefits2021-04-010
Number of other retired or separated participants entitled to future benefits2021-04-010
Total of all active and inactive participants2021-04-0196
2020: FAMILY SERVICE OF THE PIEDMONT, INC. GROUP HEALTH PLAN 2020 401k membership
Total participants, beginning-of-year2020-04-01103
Total number of active participants reported on line 7a of the Form 55002020-04-01119
Number of retired or separated participants receiving benefits2020-04-010
Number of other retired or separated participants entitled to future benefits2020-04-010
Total of all active and inactive participants2020-04-01119

Form 5500 Responses for FAMILY SERVICE OF THE PIEDMONT, INC. GROUP HEALTH PLAN

2023: FAMILY SERVICE OF THE PIEDMONT, INC. GROUP HEALTH PLAN 2023 form 5500 responses
2023-04-01Type of plan entitySingle employer plan
2023-04-01Submission has been amendedNo
2023-04-01This submission is the final filingNo
2023-04-01This return/report is a short plan year return/report (less than 12 months)No
2023-04-01Plan is a collectively bargained planNo
2023-04-01Plan funding arrangement – InsuranceYes
2023-04-01Plan benefit arrangement – InsuranceYes
2022: FAMILY SERVICE OF THE PIEDMONT, INC. GROUP HEALTH PLAN 2022 form 5500 responses
2022-04-01Type of plan entitySingle employer plan
2022-04-01Submission has been amendedNo
2022-04-01This submission is the final filingNo
2022-04-01This return/report is a short plan year return/report (less than 12 months)No
2022-04-01Plan is a collectively bargained planNo
2022-04-01Plan funding arrangement – InsuranceYes
2022-04-01Plan benefit arrangement – InsuranceYes
2021: FAMILY SERVICE OF THE PIEDMONT, INC. GROUP HEALTH PLAN 2021 form 5500 responses
2021-04-01Type of plan entitySingle employer plan
2021-04-01Submission has been amendedNo
2021-04-01This submission is the final filingNo
2021-04-01This return/report is a short plan year return/report (less than 12 months)No
2021-04-01Plan is a collectively bargained planNo
2021-04-01Plan funding arrangement – InsuranceYes
2021-04-01Plan benefit arrangement – InsuranceYes
2020: FAMILY SERVICE OF THE PIEDMONT, INC. GROUP HEALTH PLAN 2020 form 5500 responses
2020-04-01Type of plan entitySingle employer plan
2020-04-01First time form 5500 has been submittedYes
2020-04-01Submission has been amendedNo
2020-04-01This submission is the final filingNo
2020-04-01This return/report is a short plan year return/report (less than 12 months)No
2020-04-01Plan is a collectively bargained planNo
2020-04-01Plan funding arrangement – InsuranceYes
2020-04-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number907958
Policy instance 1
Insurance contract or identification number907958
Number of Individuals Covered164
Insurance policy start date2023-04-01
Insurance policy end date2024-03-31
Total amount of commissions paid to insurance brokerUSD $6,082
Total amount of fees paid to insurance companyUSD $40,629
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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 CarrierUSD $867,510
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number0907958
Policy instance 1
Insurance contract or identification number0907958
Number of Individuals Covered166
Insurance policy start date2022-04-01
Insurance policy end date2023-03-31
Total amount of commissions paid to insurance brokerUSD $6,165
Total amount of fees paid to insurance companyUSD $44,775
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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 CarrierUSD $866,035
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number0907958
Policy instance 1
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number0907958
Policy instance 1

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