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| Plan Name | EDEN HOME, INC. |
| Plan identification number | 502 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | EDEN HOME INC. |
| Employer identification number (EIN): | 741143030 |
| NAIC Classification: | 623000 |
| NAIC Description: | Nursing and Residential Care Facilities |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 502 | 2022-01-29 | JAMARA RODRIGUEZ | 2023-09-14 |
| Measure | Date | Value |
|---|---|---|
| 2022: EDEN HOME, INC. 2022 401k membership | ||
| Total participants, beginning-of-year | 2022-01-29 | 220 |
| Total number of active participants reported on line 7a of the Form 5500 | 2022-01-29 | 209 |
| Number of retired or separated participants receiving benefits | 2022-01-29 | 3 |
| Number of other retired or separated participants entitled to future benefits | 2022-01-29 | 0 |
| Total of all active and inactive participants | 2022-01-29 | 212 |
| 2022: EDEN HOME, INC. 2022 form 5500 responses | ||
|---|---|---|
| 2022-01-29 | Type of plan entity | Single employer plan |
| 2022-01-29 | First time form 5500 has been submitted | Yes |
| 2022-01-29 | Submission has been amended | Yes |
| 2022-01-29 | This submission is the final filing | No |
| 2022-01-29 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2022-01-29 | Plan is a collectively bargained plan | No |
| 2022-01-29 | Plan funding arrangement – Insurance | Yes |
| 2022-01-29 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2022-01-29 | Plan benefit arrangement – Insurance | Yes |
| 2022-01-29 | Plan benefit arrangement – General assets of the sponsor | Yes |
| THIRD COAST INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 10713 ) | |||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | 16535 | ||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||||||||||||||||||||||
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