CEDAR LAKE LODGE GROUP ACCIDENT CRITICAL ILLNESS LEGAL INSURANCE PLAN 401k Plan overview

CEDAR LAKE LODGE GROUP ACCIDENT CRITICAL ILLNESS LEGAL INSURANCE PLAN Benefits

401k Sponsoring company profile

Company Name:	CEDAR LAKE LODGE, INC.
Employer identification number (EIN):	610713587
NAIC Classification:	623000
NAIC Description:	Nursing and Residential Care Facilities

Additional information about CEDAR LAKE LODGE, INC.

Jurisdiction of Incorporation:	New York Department of State
Incorporation Date:	1991-06-25
Company Identification Number:	1557491
Legal Registered Office Address:	43 WAYNE AVENUE Rockland STONY POINT United States of America (USA) 10980

More information about CEDAR LAKE LODGE, INC.

Form 5500 Filing Information

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
505	2021-09-01	MARGARET WAUGH	2023-03-22
505	2020-09-01	MARGARET WAUGH	2022-01-19
505	2019-09-01	MARGARET WAUGH	2021-02-03
505	2018-09-01	MARGARET WAUGH	2020-05-18

Plan Statistics for CEDAR LAKE LODGE GROUP ACCIDENT CRITICAL ILLNESS LEGAL INSURANCE PLAN

Measure	Date	Value
2021: CEDAR LAKE LODGE GROUP ACCIDENT CRITICAL ILLNESS LEGAL INSURANCE PLAN 2021 401k membership
Total participants, beginning-of-year	2021-09-01	144
Total number of active participants reported on line 7a of the Form 5500	2021-09-01	52
Number of retired or separated participants receiving benefits	2021-09-01	0
Number of other retired or separated participants entitled to future benefits	2021-09-01	0
Total of all active and inactive participants	2021-09-01	52
Number of employers contributing to the scheme	2021-09-01	0
2020: CEDAR LAKE LODGE GROUP ACCIDENT CRITICAL ILLNESS LEGAL INSURANCE PLAN 2020 401k membership
Total participants, beginning-of-year	2020-09-01	280
Total number of active participants reported on line 7a of the Form 5500	2020-09-01	144
Number of retired or separated participants receiving benefits	2020-09-01	0
Number of other retired or separated participants entitled to future benefits	2020-09-01	0
Total of all active and inactive participants	2020-09-01	144
Number of employers contributing to the scheme	2020-09-01	0
2019: CEDAR LAKE LODGE GROUP ACCIDENT CRITICAL ILLNESS LEGAL INSURANCE PLAN 2019 401k membership
Total participants, beginning-of-year	2019-09-01	113
Total number of active participants reported on line 7a of the Form 5500	2019-09-01	280
Number of retired or separated participants receiving benefits	2019-09-01	0
Number of other retired or separated participants entitled to future benefits	2019-09-01	0
Total of all active and inactive participants	2019-09-01	280
Number of employers contributing to the scheme	2019-09-01	0
2018: CEDAR LAKE LODGE GROUP ACCIDENT CRITICAL ILLNESS LEGAL INSURANCE PLAN 2018 401k membership
Total participants, beginning-of-year	2018-09-01	100
Total number of active participants reported on line 7a of the Form 5500	2018-09-01	113
Number of retired or separated participants receiving benefits	2018-09-01	0
Number of other retired or separated participants entitled to future benefits	2018-09-01	0
Total of all active and inactive participants	2018-09-01	113
Number of employers contributing to the scheme	2018-09-01	0

Form 5500 Responses for CEDAR LAKE LODGE GROUP ACCIDENT CRITICAL ILLNESS LEGAL INSURANCE PLAN

Insurance Providers Used on plan

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