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MEDICAL PLAN 401k Plan overview

Plan NameMEDICAL PLAN
Plan identification number 501

MEDICAL PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Unfunded, fully insured, or combination unfunded/insured welfare plan that will not file a Form 5500 for next plan year pursuant to 29 CFR 2520.104-20.
  • Unfunded, fully insured, or combination unfunded/insured welfare plan that stopped filing form 5500s in an earlier plan year pursuant to 29 CFR 2520.104-20.

401k Sponsoring company profile

PROTHERA INC. has sponsored the creation of one or more 401k plans.

Company Name:PROTHERA INC.
Employer identification number (EIN):880487638
NAIC Classification:325410

Additional information about PROTHERA INC.

Jurisdiction of Incorporation: Nevada Department of State
Incorporation Date: 2001-01-25
Company Identification Number: 20011196269
Legal Registered Office Address: 10439 DOUBLE R BLVD

RENO
United States of America (USA)
89521

More information about PROTHERA INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan MEDICAL PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012022-03-01ROBERT HENDRIKS2023-08-27
5012021-03-01DOUG HARVEY2022-08-01
5012020-03-01DOUG HARVEY2021-08-12
5012019-03-01DOUGLAS HARVEY2020-09-17
5012018-03-01DOUGLAS HARVEY2019-12-16
5012017-03-01

Plan Statistics for MEDICAL PLAN

401k plan membership statisitcs for MEDICAL PLAN

Measure Date Value
2022: MEDICAL PLAN 2022 401k membership
Total participants, beginning-of-year2022-03-01131
Total number of active participants reported on line 7a of the Form 55002022-03-01124
Number of retired or separated participants receiving benefits2022-03-010
Number of other retired or separated participants entitled to future benefits2022-03-010
Total of all active and inactive participants2022-03-01124
Number of employers contributing to the scheme2022-03-010
2021: MEDICAL PLAN 2021 401k membership
Total participants, beginning-of-year2021-03-01130
Total number of active participants reported on line 7a of the Form 55002021-03-01131
Number of retired or separated participants receiving benefits2021-03-010
Number of other retired or separated participants entitled to future benefits2021-03-010
Total of all active and inactive participants2021-03-01131
Number of employers contributing to the scheme2021-03-010
2020: MEDICAL PLAN 2020 401k membership
Total participants, beginning-of-year2020-03-0198
Total number of active participants reported on line 7a of the Form 55002020-03-01130
Number of retired or separated participants receiving benefits2020-03-010
Number of other retired or separated participants entitled to future benefits2020-03-010
Total of all active and inactive participants2020-03-01130
Number of employers contributing to the scheme2020-03-010
2019: MEDICAL PLAN 2019 401k membership
Total participants, beginning-of-year2019-03-01108
Total number of active participants reported on line 7a of the Form 55002019-03-0198
Number of retired or separated participants receiving benefits2019-03-010
Number of other retired or separated participants entitled to future benefits2019-03-010
Total of all active and inactive participants2019-03-0198
Number of employers contributing to the scheme2019-03-010
2018: MEDICAL PLAN 2018 401k membership
Total participants, beginning-of-year2018-03-01100
Total number of active participants reported on line 7a of the Form 55002018-03-01108
Number of retired or separated participants receiving benefits2018-03-010
Number of other retired or separated participants entitled to future benefits2018-03-010
Total of all active and inactive participants2018-03-01108
Number of employers contributing to the scheme2018-03-010
2017: MEDICAL PLAN 2017 401k membership
Total participants, beginning-of-year2017-03-01100
Total number of active participants reported on line 7a of the Form 55002017-03-01100
Number of retired or separated participants receiving benefits2017-03-010
Number of other retired or separated participants entitled to future benefits2017-03-010
Total of all active and inactive participants2017-03-01100

Form 5500 Responses for MEDICAL PLAN

2022: MEDICAL PLAN 2022 form 5500 responses
2022-03-01Type of plan entitySingle employer plan
2022-03-01Plan funding arrangement – InsuranceYes
2022-03-01Plan benefit arrangement – InsuranceYes
2021: MEDICAL PLAN 2021 form 5500 responses
2021-03-01Type of plan entitySingle employer plan
2021-03-01Plan funding arrangement – InsuranceYes
2021-03-01Plan benefit arrangement – InsuranceYes
2020: MEDICAL PLAN 2020 form 5500 responses
2020-03-01Type of plan entitySingle employer plan
2020-03-01Plan funding arrangement – InsuranceYes
2020-03-01Plan benefit arrangement – InsuranceYes
2019: MEDICAL PLAN 2019 form 5500 responses
2019-03-01Type of plan entitySingle employer plan
2019-03-01Plan funding arrangement – InsuranceYes
2019-03-01Plan benefit arrangement – InsuranceYes
2018: MEDICAL PLAN 2018 form 5500 responses
2018-03-01Type of plan entitySingle employer plan
2018-03-01Plan funding arrangement – InsuranceYes
2018-03-01Plan benefit arrangement – InsuranceYes
2017: MEDICAL PLAN 2017 form 5500 responses
2017-03-01Type of plan entitySingle employer plan
2017-03-01First time form 5500 has been submittedYes
2017-03-01Plan funding arrangement – InsuranceYes
2017-03-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

ROCKY MOUNTAIN HOSPITAL AND MEDICAL SERVICE, INC. (National Association of Insurance Commissioners NAIC id number: 11011 )
Policy contract number196035
Policy instance 1
Insurance contract or identification number196035
Number of Individuals Covered228
Insurance policy start date2022-03-01
Insurance policy end date2023-02-28
Total amount of commissions paid to insurance brokerUSD $55,008
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,091,321
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $55,008
Amount paid for insurance broker fees0
Insurance broker organization code?3
ROCKY MOUNTAIN HOSPITAL AND MEDICAL SERVICE, INC. (National Association of Insurance Commissioners NAIC id number: 11011 )
Policy contract number196035
Policy instance 1
Insurance contract or identification number196035
Number of Individuals Covered264
Insurance policy start date2021-03-01
Insurance policy end date2022-02-28
Total amount of commissions paid to insurance brokerUSD $60,380
Total amount of fees paid to insurance companyUSD $2,374
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,125,037
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $60,380
Amount paid for insurance broker fees2374
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
ROCKY MOUNTAIN HOSPITAL AND MEDICAL SERVICE, INC. (National Association of Insurance Commissioners NAIC id number: 11011 )
Policy contract number196035
Policy instance 1
Insurance contract or identification number196035
Number of Individuals Covered255
Insurance policy start date2020-03-01
Insurance policy end date2021-02-28
Total amount of commissions paid to insurance brokerUSD $44,460
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,035,049
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $44,460
Amount paid for insurance broker fees0
ROCKY MOUNTAIN HOSPITAL AND MEDICAL SERVICE, INC. (National Association of Insurance Commissioners NAIC id number: 11011 )
Policy contract number196035
Policy instance 1
Insurance contract or identification number196035
Number of Individuals Covered211
Insurance policy start date2019-03-01
Insurance policy end date2020-02-28
Total amount of commissions paid to insurance brokerUSD $36,210
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $744,572
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $36,210
Amount paid for insurance broker fees0
Insurance broker organization code?3
ANTHEM BLUE CROSS AND BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 95473 )
Policy contract number196035
Policy instance 1
Insurance contract or identification number196035
Number of Individuals Covered2
Insurance policy start date2017-03-01
Insurance policy end date2018-02-28
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $23,008
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
ROCKY MOUNTAIN HOSPITAL AND MEDICAL SERVICE, INC. (National Association of Insurance Commissioners NAIC id number: 11011 )
Policy contract number196035
Policy instance 2
Insurance contract or identification number196035
Number of Individuals Covered118
Insurance policy start date2017-03-01
Insurance policy end date2018-02-28
Total amount of commissions paid to insurance brokerUSD $38,760
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $727,249
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $38,760
Amount paid for insurance broker fees0
Insurance broker organization code?3
Insurance broker nameLP INSURANCE SERVICES, INC.

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