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AVE MARIA HOME ACCIDENT, TERM LIFE 401k Plan overview

Plan NameAVE MARIA HOME ACCIDENT, TERM LIFE
Plan identification number 503

AVE MARIA HOME ACCIDENT, TERM LIFE Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Life insurance
  • Other welfare benefit cover

401k Sponsoring company profile

AVE MARIA HOME has sponsored the creation of one or more 401k plans.

Company Name:AVE MARIA HOME
Employer identification number (EIN):620561701
NAIC Classification:623000
NAIC Description: Nursing and Residential Care Facilities

Form 5500 Filing Information

Submission information for form 5500 for 401k plan AVE MARIA HOME ACCIDENT, TERM LIFE

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5032021-10-01CRAIG HOFER2023-05-23
5032020-10-01FRANK GATTUSO2022-06-30
5032019-11-01FRANK GATTUSO2021-06-30
5032018-11-01FRANK GATTUSO2020-06-02
5032017-11-01
5032016-11-01
5032015-11-01
5032014-11-01

Plan Statistics for AVE MARIA HOME ACCIDENT, TERM LIFE

401k plan membership statisitcs for AVE MARIA HOME ACCIDENT, TERM LIFE

Measure Date Value
2021: AVE MARIA HOME ACCIDENT, TERM LIFE 2021 401k membership
Total participants, beginning-of-year2021-10-01144
Total number of active participants reported on line 7a of the Form 55002021-10-01189
Total of all active and inactive participants2021-10-01189
2020: AVE MARIA HOME ACCIDENT, TERM LIFE 2020 401k membership
Total participants, beginning-of-year2020-10-01184
Total number of active participants reported on line 7a of the Form 55002020-10-01144
Total of all active and inactive participants2020-10-01144
2019: AVE MARIA HOME ACCIDENT, TERM LIFE 2019 401k membership
Total participants, beginning-of-year2019-11-01191
Total number of active participants reported on line 7a of the Form 55002019-11-01184
Total of all active and inactive participants2019-11-01184
2018: AVE MARIA HOME ACCIDENT, TERM LIFE 2018 401k membership
Total participants, beginning-of-year2018-11-01197
Total number of active participants reported on line 7a of the Form 55002018-11-01191
Total of all active and inactive participants2018-11-01191
2017: AVE MARIA HOME ACCIDENT, TERM LIFE 2017 401k membership
Total participants, beginning-of-year2017-11-01217
Total number of active participants reported on line 7a of the Form 55002017-11-01197
Total of all active and inactive participants2017-11-01197
2016: AVE MARIA HOME ACCIDENT, TERM LIFE 2016 401k membership
Total participants, beginning-of-year2016-11-01205
Total number of active participants reported on line 7a of the Form 55002016-11-01217
Total of all active and inactive participants2016-11-01217
2015: AVE MARIA HOME ACCIDENT, TERM LIFE 2015 401k membership
Total participants, beginning-of-year2015-11-01208
Total number of active participants reported on line 7a of the Form 55002015-11-01205
Total of all active and inactive participants2015-11-01205
2014: AVE MARIA HOME ACCIDENT, TERM LIFE 2014 401k membership
Total participants, beginning-of-year2014-11-01207
Total number of active participants reported on line 7a of the Form 55002014-11-01208
Total of all active and inactive participants2014-11-01208

Form 5500 Responses for AVE MARIA HOME ACCIDENT, TERM LIFE

2021: AVE MARIA HOME ACCIDENT, TERM LIFE 2021 form 5500 responses
2021-10-01Type of plan entitySingle employer plan
2021-10-01Plan funding arrangement – InsuranceYes
2021-10-01Plan benefit arrangement – InsuranceYes
2020: AVE MARIA HOME ACCIDENT, TERM LIFE 2020 form 5500 responses
2020-10-01Type of plan entitySingle employer plan
2020-10-01Plan funding arrangement – InsuranceYes
2020-10-01Plan benefit arrangement – InsuranceYes
2019: AVE MARIA HOME ACCIDENT, TERM LIFE 2019 form 5500 responses
2019-11-01Type of plan entitySingle employer plan
2019-11-01This return/report is a short plan year return/report (less than 12 months)Yes
2019-11-01Plan funding arrangement – InsuranceYes
2019-11-01Plan benefit arrangement – InsuranceYes
2018: AVE MARIA HOME ACCIDENT, TERM LIFE 2018 form 5500 responses
2018-11-01Type of plan entitySingle employer plan
2018-11-01Plan funding arrangement – InsuranceYes
2018-11-01Plan benefit arrangement – InsuranceYes
2017: AVE MARIA HOME ACCIDENT, TERM LIFE 2017 form 5500 responses
2017-11-01Type of plan entitySingle employer plan
2017-11-01Plan funding arrangement – InsuranceYes
2017-11-01Plan benefit arrangement – InsuranceYes
2016: AVE MARIA HOME ACCIDENT, TERM LIFE 2016 form 5500 responses
2016-11-01Type of plan entitySingle employer plan
2016-11-01Plan funding arrangement – InsuranceYes
2016-11-01Plan benefit arrangement – InsuranceYes
2015: AVE MARIA HOME ACCIDENT, TERM LIFE 2015 form 5500 responses
2015-11-01Type of plan entitySingle employer plan
2015-11-01Plan funding arrangement – InsuranceYes
2015-11-01Plan benefit arrangement – InsuranceYes
2014: AVE MARIA HOME ACCIDENT, TERM LIFE 2014 form 5500 responses
2014-11-01Type of plan entitySingle employer plan
2014-11-01First time form 5500 has been submittedYes
2014-11-01Plan funding arrangement – InsuranceYes
2014-11-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number858027G
Policy instance 1
Insurance contract or identification number858027G
Number of Individuals Covered189
Insurance policy start date2021-10-01
Insurance policy end date2022-09-30
Total amount of commissions paid to insurance brokerUSD $3,906
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $26,036
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,906
Insurance broker organization code?3
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number858027G
Policy instance 1
Insurance contract or identification number858027G
Number of Individuals Covered144
Insurance policy start date2020-10-01
Insurance policy end date2021-09-30
Total amount of commissions paid to insurance brokerUSD $4,648
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $31,336
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,648
Insurance broker organization code?3
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number858027G
Policy instance 1
Insurance contract or identification number858027G
Number of Individuals Covered184
Insurance policy start date2019-11-01
Insurance policy end date2020-09-30
Total amount of commissions paid to insurance brokerUSD $576
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $3,490
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $576
Insurance broker organization code?3
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number858027G
Policy instance 1
Insurance contract or identification number858027G
Number of Individuals Covered191
Insurance policy start date2018-11-01
Insurance policy end date2019-10-31
Total amount of commissions paid to insurance brokerUSD $789
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $5,441
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $789
Insurance broker organization code?3
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number858027G
Policy instance 1
Insurance contract or identification number858027G
Number of Individuals Covered197
Insurance policy start date2017-11-01
Insurance policy end date2018-10-31
Total amount of commissions paid to insurance brokerUSD $642
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $4,520
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number858027G
Policy instance 1
Insurance contract or identification number858027G
Number of Individuals Covered205
Insurance policy start date2015-11-01
Insurance policy end date2016-10-31
Total amount of commissions paid to insurance brokerUSD $681
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $4,540
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $681
Insurance broker organization code?3
Insurance broker nameHARVEY INSURANCE RESOURCES LLC
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number858027G
Policy instance 1
Insurance contract or identification number858027G
Number of Individuals Covered208
Insurance policy start date2014-11-01
Insurance policy end date2015-10-31
Total amount of commissions paid to insurance brokerUSD $764
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $5,094
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $764
Insurance broker organization code?3
Insurance broker nameHARVEY INSURANCE RESOURCES LLC

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