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SENIOR SERVICES OF AMERICA, LLC WELFARE BENEFIT PLAN 401k Plan overview

Plan NameSENIOR SERVICES OF AMERICA, LLC WELFARE BENEFIT PLAN
Plan identification number 501

SENIOR SERVICES OF AMERICA, LLC WELFARE BENEFIT PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Vision
  • Temporary disability (accident and sickness)
  • Long-term disability cover
  • Death benefits (include travel accident but not life insurance)
  • Other welfare benefit cover
  • 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.

401k Sponsoring company profile

SENIOR SERVICES OF AMERICA, LLC has sponsored the creation of one or more 401k plans.

Company Name:SENIOR SERVICES OF AMERICA, LLC
Employer identification number (EIN):912108501
NAIC Classification:623000
NAIC Description: Nursing and Residential Care Facilities

Additional information about SENIOR SERVICES OF AMERICA, LLC

Jurisdiction of Incorporation: Washington Secretary of State Corporations Division
Incorporation Date: 2000-08-30
Company Identification Number: 602062064
Legal Registered Office Address: 1201 PACIFIC AVE STE 450

TACOMA
United States of America (USA)
984020000

More information about SENIOR SERVICES OF AMERICA, LLC

Form 5500 Filing Information

Submission information for form 5500 for 401k plan SENIOR SERVICES OF AMERICA, LLC WELFARE BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012021-01-01RANDY TRETTEVIK2022-03-23
5012020-01-01RANDY TRETTEVIK2021-07-13
5012019-01-01RANDY TRETTEVIK2020-09-16
5012018-01-01
5012017-01-01
5012016-01-01SARA LEICK
5012015-02-01SARA LEICK
5012014-02-01SARA LEICK
5012013-02-01SARA LEICK
5012012-02-01SARA LEICK
5012011-02-01SARA LEICK
5012010-02-01SARA LEICK
5012009-06-01KARLARAE ELLIS
5012009-02-01KARLARAE ELLIS KARLARAE ELLIS2010-08-25

Plan Statistics for SENIOR SERVICES OF AMERICA, LLC WELFARE BENEFIT PLAN

401k plan membership statisitcs for SENIOR SERVICES OF AMERICA, LLC WELFARE BENEFIT PLAN

Measure Date Value
2021: SENIOR SERVICES OF AMERICA, LLC WELFARE BENEFIT PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-01413
Total number of active participants reported on line 7a of the Form 55002021-01-0148
Number of retired or separated participants receiving benefits2021-01-010
Number of other retired or separated participants entitled to future benefits2021-01-010
Total of all active and inactive participants2021-01-0148
Number of employers contributing to the scheme2021-01-010
2020: SENIOR SERVICES OF AMERICA, LLC WELFARE BENEFIT PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-01476
Total number of active participants reported on line 7a of the Form 55002020-01-01413
Number of retired or separated participants receiving benefits2020-01-010
Number of other retired or separated participants entitled to future benefits2020-01-010
Total of all active and inactive participants2020-01-01413
Number of employers contributing to the scheme2020-01-010
2019: SENIOR SERVICES OF AMERICA, LLC WELFARE BENEFIT PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-01816
Total number of active participants reported on line 7a of the Form 55002019-01-01476
Number of retired or separated participants receiving benefits2019-01-010
Number of other retired or separated participants entitled to future benefits2019-01-010
Total of all active and inactive participants2019-01-01476
Number of employers contributing to the scheme2019-01-010
2018: SENIOR SERVICES OF AMERICA, LLC WELFARE BENEFIT PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-01220
Total number of active participants reported on line 7a of the Form 55002018-01-01816
Number of retired or separated participants receiving benefits2018-01-010
Number of other retired or separated participants entitled to future benefits2018-01-010
Total of all active and inactive participants2018-01-01816
Number of employers contributing to the scheme2018-01-010
2017: SENIOR SERVICES OF AMERICA, LLC WELFARE BENEFIT PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-01220
Total number of active participants reported on line 7a of the Form 55002017-01-01220
Number of retired or separated participants receiving benefits2017-01-010
Number of other retired or separated participants entitled to future benefits2017-01-010
Total of all active and inactive participants2017-01-01220
2016: SENIOR SERVICES OF AMERICA, LLC WELFARE BENEFIT PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-01850
Total number of active participants reported on line 7a of the Form 55002016-01-01850
Number of retired or separated participants receiving benefits2016-01-010
Number of other retired or separated participants entitled to future benefits2016-01-010
Total of all active and inactive participants2016-01-01850
2015: SENIOR SERVICES OF AMERICA, LLC WELFARE BENEFIT PLAN 2015 401k membership
Total participants, beginning-of-year2015-02-01850
Total number of active participants reported on line 7a of the Form 55002015-02-01850
Number of retired or separated participants receiving benefits2015-02-010
Number of other retired or separated participants entitled to future benefits2015-02-010
Total of all active and inactive participants2015-02-01850
2014: SENIOR SERVICES OF AMERICA, LLC WELFARE BENEFIT PLAN 2014 401k membership
Total participants, beginning-of-year2014-02-01852
Total number of active participants reported on line 7a of the Form 55002014-02-01850
Number of retired or separated participants receiving benefits2014-02-010
Number of other retired or separated participants entitled to future benefits2014-02-010
Total of all active and inactive participants2014-02-01850
2013: SENIOR SERVICES OF AMERICA, LLC WELFARE BENEFIT PLAN 2013 401k membership
Total participants, beginning-of-year2013-02-01233
Total number of active participants reported on line 7a of the Form 55002013-02-01850
Number of retired or separated participants receiving benefits2013-02-012
Number of other retired or separated participants entitled to future benefits2013-02-010
Total of all active and inactive participants2013-02-01852
2012: SENIOR SERVICES OF AMERICA, LLC WELFARE BENEFIT PLAN 2012 401k membership
Total participants, beginning-of-year2012-02-01137
Total number of active participants reported on line 7a of the Form 55002012-02-01231
Number of retired or separated participants receiving benefits2012-02-012
Number of other retired or separated participants entitled to future benefits2012-02-010
Total of all active and inactive participants2012-02-01233
2011: SENIOR SERVICES OF AMERICA, LLC WELFARE BENEFIT PLAN 2011 401k membership
Total participants, beginning-of-year2011-02-01147
Total number of active participants reported on line 7a of the Form 55002011-02-01135
Number of retired or separated participants receiving benefits2011-02-012
Number of other retired or separated participants entitled to future benefits2011-02-010
Total of all active and inactive participants2011-02-01137
2010: SENIOR SERVICES OF AMERICA, LLC WELFARE BENEFIT PLAN 2010 401k membership
Total participants, beginning-of-year2010-02-01234
Total number of active participants reported on line 7a of the Form 55002010-02-01145
Number of retired or separated participants receiving benefits2010-02-012
Number of other retired or separated participants entitled to future benefits2010-02-010
Total of all active and inactive participants2010-02-01147
2009: SENIOR SERVICES OF AMERICA, LLC WELFARE BENEFIT PLAN 2009 401k membership
Total participants, beginning-of-year2009-06-01126
Total number of active participants reported on line 7a of the Form 55002009-06-010
Number of retired or separated participants receiving benefits2009-06-010
Number of other retired or separated participants entitled to future benefits2009-06-010
Total of all active and inactive participants2009-06-010
Total participants2009-06-010
Total participants, beginning-of-year2009-02-01127
Total number of active participants reported on line 7a of the Form 55002009-02-01229
Number of retired or separated participants receiving benefits2009-02-015
Number of other retired or separated participants entitled to future benefits2009-02-010
Total of all active and inactive participants2009-02-01234
Total participants2009-02-010

Form 5500 Responses for SENIOR SERVICES OF AMERICA, LLC WELFARE BENEFIT PLAN

2021: SENIOR SERVICES OF AMERICA, LLC WELFARE BENEFIT PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan funding arrangement – General assets of the sponsorYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement – General assets of the sponsorYes
2020: SENIOR SERVICES OF AMERICA, LLC WELFARE BENEFIT PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan funding arrangement – General assets of the sponsorYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement – General assets of the sponsorYes
2019: SENIOR SERVICES OF AMERICA, LLC WELFARE BENEFIT PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan funding arrangement – General assets of the sponsorYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement – General assets of the sponsorYes
2018: SENIOR SERVICES OF AMERICA, LLC WELFARE BENEFIT PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan funding arrangement – General assets of the sponsorYes
2018-01-01Plan benefit arrangement – InsuranceYes
2018-01-01Plan benefit arrangement – General assets of the sponsorYes
2017: SENIOR SERVICES OF AMERICA, LLC WELFARE BENEFIT PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan funding arrangement – General assets of the sponsorYes
2017-01-01Plan benefit arrangement – InsuranceYes
2017-01-01Plan benefit arrangement – General assets of the sponsorYes
2016: SENIOR SERVICES OF AMERICA, LLC WELFARE BENEFIT PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Submission has been amendedNo
2016-01-01This submission is the final filingNo
2016-01-01This return/report is a short plan year return/report (less than 12 months)No
2016-01-01Plan is a collectively bargained planNo
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan funding arrangement – General assets of the sponsorYes
2016-01-01Plan benefit arrangement – InsuranceYes
2016-01-01Plan benefit arrangement – General assets of the sponsorYes
2015: SENIOR SERVICES OF AMERICA, LLC WELFARE BENEFIT PLAN 2015 form 5500 responses
2015-02-01Type of plan entitySingle employer plan
2015-02-01Submission has been amendedNo
2015-02-01This submission is the final filingNo
2015-02-01This return/report is a short plan year return/report (less than 12 months)Yes
2015-02-01Plan is a collectively bargained planNo
2015-02-01Plan funding arrangement – InsuranceYes
2015-02-01Plan funding arrangement – General assets of the sponsorYes
2015-02-01Plan benefit arrangement – InsuranceYes
2015-02-01Plan benefit arrangement – General assets of the sponsorYes
2014: SENIOR SERVICES OF AMERICA, LLC WELFARE BENEFIT PLAN 2014 form 5500 responses
2014-02-01Type of plan entitySingle employer plan
2014-02-01Submission has been amendedNo
2014-02-01This submission is the final filingNo
2014-02-01This return/report is a short plan year return/report (less than 12 months)No
2014-02-01Plan is a collectively bargained planNo
2014-02-01Plan funding arrangement – InsuranceYes
2014-02-01Plan funding arrangement – General assets of the sponsorYes
2014-02-01Plan benefit arrangement – InsuranceYes
2014-02-01Plan benefit arrangement – General assets of the sponsorYes
2013: SENIOR SERVICES OF AMERICA, LLC WELFARE BENEFIT PLAN 2013 form 5500 responses
2013-02-01Type of plan entitySingle employer plan
2013-02-01Submission has been amendedNo
2013-02-01This submission is the final filingNo
2013-02-01This return/report is a short plan year return/report (less than 12 months)No
2013-02-01Plan is a collectively bargained planNo
2013-02-01Plan funding arrangement – InsuranceYes
2013-02-01Plan funding arrangement – General assets of the sponsorYes
2013-02-01Plan benefit arrangement – InsuranceYes
2013-02-01Plan benefit arrangement – General assets of the sponsorYes
2012: SENIOR SERVICES OF AMERICA, LLC WELFARE BENEFIT PLAN 2012 form 5500 responses
2012-02-01Type of plan entitySingle employer plan
2012-02-01Submission has been amendedNo
2012-02-01This submission is the final filingNo
2012-02-01This return/report is a short plan year return/report (less than 12 months)No
2012-02-01Plan is a collectively bargained planNo
2012-02-01Plan funding arrangement – InsuranceYes
2012-02-01Plan funding arrangement – General assets of the sponsorYes
2012-02-01Plan benefit arrangement – InsuranceYes
2012-02-01Plan benefit arrangement – General assets of the sponsorYes
2011: SENIOR SERVICES OF AMERICA, LLC WELFARE BENEFIT PLAN 2011 form 5500 responses
2011-02-01Type of plan entitySingle employer plan
2011-02-01Submission has been amendedYes
2011-02-01This submission is the final filingNo
2011-02-01This return/report is a short plan year return/report (less than 12 months)No
2011-02-01Plan is a collectively bargained planNo
2011-02-01Plan funding arrangement – InsuranceYes
2011-02-01Plan benefit arrangement – InsuranceYes
2010: SENIOR SERVICES OF AMERICA, LLC WELFARE BENEFIT PLAN 2010 form 5500 responses
2010-02-01Type of plan entitySingle employer plan
2010-02-01Submission has been amendedYes
2010-02-01This submission is the final filingNo
2010-02-01This return/report is a short plan year return/report (less than 12 months)No
2010-02-01Plan is a collectively bargained planNo
2010-02-01Plan funding arrangement – InsuranceYes
2010-02-01Plan benefit arrangement – InsuranceYes
2009: SENIOR SERVICES OF AMERICA, LLC WELFARE BENEFIT PLAN 2009 form 5500 responses
2009-06-01Type of plan entitySingle employer plan
2009-06-01Submission has been amendedNo
2009-06-01This submission is the final filingYes
2009-06-01This return/report is a short plan year return/report (less than 12 months)Yes
2009-06-01Plan is a collectively bargained planNo
2009-06-01Plan funding arrangement – InsuranceYes
2009-06-01Plan benefit arrangement – InsuranceYes
2009-02-01Type of plan entitySingle employer plan
2009-02-01Submission has been amendedNo
2009-02-01This submission is the final filingNo
2009-02-01This return/report is a short plan year return/report (less than 12 months)No
2009-02-01Plan is a collectively bargained planNo
2009-02-01Plan funding arrangement – InsuranceYes
2009-02-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGLUG0BQ2M
Policy instance 2
CURALINC HEALTHCARE (National Association of Insurance Commissioners NAIC id number: 62419 )
Policy contract number00
Policy instance 1
CURALINC HEALTHCARE (National Association of Insurance Commissioners NAIC id number: 62419 )
Policy contract number00
Policy instance 2
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number5941610
Policy instance 1
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number5941610
Policy instance 1
CURALINC HEALTHCARE (National Association of Insurance Commissioners NAIC id number: 62419 )
Policy contract number00
Policy instance 2
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract numberKM05941610
Policy instance 1
CURALINC HEALTHCARE (National Association of Insurance Commissioners NAIC id number: 62419 )
Policy contract number00
Policy instance 2
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number05941610
Policy instance 1
UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 )
Policy contract number5233957
Policy instance 2
COMPSYCH (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number00
Policy instance 3
COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: 77828 )
Policy contract numberCADM1017
Policy instance 1
COMPSYCH (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number00
Policy instance 3
COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: 77828 )
Policy contract numberCADM1017
Policy instance 2
UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 )
Policy contract number5233957
Policy instance 1
COMPSYCH (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number00
Policy instance 3
COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: 77828 )
Policy contract numberCADM1017
Policy instance 2
UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 )
Policy contract number5233957
Policy instance 1
COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60049 )
Policy contract numberE3411907
Policy instance 2
UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 )
Policy contract number5233957
Policy instance 1
PREMERA BLUE CROSS (National Association of Insurance Commissioners NAIC id number: 47570 )
Policy contract number1033619
Policy instance 3
COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60049 )
Policy contract numberE3411907
Policy instance 3
UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 )
Policy contract number604277
Policy instance 2
PREMERA BLUE CROSS (National Association of Insurance Commissioners NAIC id number: 47570 )
Policy contract number1033619
Policy instance 1
COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60049 )
Policy contract numberE3411907
Policy instance 3
PREMERA BLUE CROSS (National Association of Insurance Commissioners NAIC id number: 47570 )
Policy contract number1033619
Policy instance 1
UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 )
Policy contract number604277/5233957
Policy instance 2

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