401k Plan data: BCBS AL plan

BCBS AL 401k Plan overview

Plan Name	BCBS AL
Plan identification number	502

BCBS AL Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) Dental

401k Sponsoring company profile

BIRMINGHAM HEALTH & REHAB LLC has sponsored the creation of one or more 401k plans.

Company Name: BIRMINGHAM HEALTH & REHAB LLC

Employer identification number (EIN): 843014044

NAIC Classification: 623000
NAIC Description: Nursing and Residential Care Facilities

Form 5500 Filing Information

Submission information for form 5500 for 401k plan BCBS AL

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
502 2022-10-01 SHALOM LERNER 2024-07-03
502 2021-10-01 SHALOM LERNER 2023-06-05
502 2020-10-01 GITTY LIPSCHITZ 2022-05-05

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
502	2022-10-01	SHALOM LERNER	2024-07-03
502	2021-10-01	SHALOM LERNER	2023-06-05
502	2020-10-01	GITTY LIPSCHITZ	2022-05-05

Plan Statistics for BCBS AL

401k plan membership statisitcs for BCBS AL

Measure Date Value
2022: BCBS AL 2022 401k membership
Total participants, beginning-of-year 2022-10-01 190
Total number of active participants reported on line 7a of the Form 5500 2022-10-01 120
Number of retired or separated participants receiving benefits 2022-10-01 0
Number of other retired or separated participants entitled to future benefits 2022-10-01 0
Total of all active and inactive participants 2022-10-01 120
Number of employers contributing to the scheme 2022-10-01 0
2021: BCBS AL 2021 401k membership
Total participants, beginning-of-year 2021-10-01 100
Total number of active participants reported on line 7a of the Form 5500 2021-10-01 185
Number of retired or separated participants receiving benefits 2021-10-01 0
Number of other retired or separated participants entitled to future benefits 2021-10-01 0
Total of all active and inactive participants 2021-10-01 185
Number of employers contributing to the scheme 2021-10-01 0
2020: BCBS AL 2020 401k membership
Total participants, beginning-of-year 2020-10-01 100
Total number of active participants reported on line 7a of the Form 5500 2020-10-01 197
Number of retired or separated participants receiving benefits 2020-10-01 0
Number of other retired or separated participants entitled to future benefits 2020-10-01 0
Total of all active and inactive participants 2020-10-01 197
Number of employers contributing to the scheme 2020-10-01 0

Measure	Date	Value
2022: BCBS AL 2022 401k membership
Total participants, beginning-of-year	2022-10-01	190
Total number of active participants reported on line 7a of the Form 5500	2022-10-01	120
Number of retired or separated participants receiving benefits	2022-10-01	0
Number of other retired or separated participants entitled to future benefits	2022-10-01	0
Total of all active and inactive participants	2022-10-01	120
Number of employers contributing to the scheme	2022-10-01	0
2021: BCBS AL 2021 401k membership
Total participants, beginning-of-year	2021-10-01	100
Total number of active participants reported on line 7a of the Form 5500	2021-10-01	185
Number of retired or separated participants receiving benefits	2021-10-01	0
Number of other retired or separated participants entitled to future benefits	2021-10-01	0
Total of all active and inactive participants	2021-10-01	185
Number of employers contributing to the scheme	2021-10-01	0
2020: BCBS AL 2020 401k membership
Total participants, beginning-of-year	2020-10-01	100
Total number of active participants reported on line 7a of the Form 5500	2020-10-01	197
Number of retired or separated participants receiving benefits	2020-10-01	0
Number of other retired or separated participants entitled to future benefits	2020-10-01	0
Total of all active and inactive participants	2020-10-01	197
Number of employers contributing to the scheme	2020-10-01	0

Form 5500 Responses for BCBS AL

2022: BCBS AL 2022 form 5500 responses
2022-10-01	Type of plan entity	Single employer plan
2022-10-01	Plan funding arrangement – Insurance	Yes
2022-10-01	Plan benefit arrangement – Insurance	Yes
2021: BCBS AL 2021 form 5500 responses
2021-10-01	Type of plan entity	Single employer plan
2021-10-01	Plan funding arrangement – Insurance	Yes
2021-10-01	Plan benefit arrangement – Insurance	Yes
2020: BCBS AL 2020 form 5500 responses
2020-10-01	Type of plan entity	Single employer plan
2020-10-01	First time form 5500 has been submitted	Yes
2020-10-01	Plan funding arrangement – Insurance	Yes
2020-10-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

BLUE CROSS BLUE SHIELD OF ALABAMA (National Association of Insurance Commissioners NAIC id number: 55433 )
Policy contract number	58115
Policy instance	1
BLUE CROSS BLUE SHIELD OF ALABAMA (National Association of Insurance Commissioners NAIC id number: 55433 )
Policy contract number	58115
Policy instance	1
BLUE CROSS BLUE SHIELD OF ALABAMA (National Association of Insurance Commissioners NAIC id number: 55433 )
Policy contract number	58115
Policy instance	1

Potentially related plans

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Company Name:	BIRMINGHAM HEALTH & REHAB LLC
Employer identification number (EIN):	843014044
NAIC Classification:	623000
NAIC Description:	Nursing and Residential Care Facilities