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WOODLANDS SENIOR LIVING, LLC EMPLOYEE GROUP DENTAL & VISION PLAN 401k Plan overview

Plan NameWOODLANDS SENIOR LIVING, LLC EMPLOYEE GROUP DENTAL & VISION PLAN
Plan identification number 503

WOODLANDS SENIOR LIVING, LLC EMPLOYEE GROUP DENTAL & VISION PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Dental
  • 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

WOODLANDS SENIOR LIVING, LLC has sponsored the creation of one or more 401k plans.

Company Name:WOODLANDS SENIOR LIVING, LLC
Employer identification number (EIN):010546232
NAIC Classification:623000
NAIC Description: Nursing and Residential Care Facilities

Form 5500 Filing Information

Submission information for form 5500 for 401k plan WOODLANDS SENIOR LIVING, LLC EMPLOYEE GROUP DENTAL & VISION PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5032020-04-01MATTHEW WALTERS2021-10-10
5032019-04-01MATTHEW WALTERS2020-12-21
5032018-04-01MATTHEW WALTERS2020-12-21
5032017-04-01MATTHEW WALTERS2020-12-21
5032016-08-01 ELIZABETH AVERY2020-12-23
5032015-08-01MATTHEW WALTERS2020-12-21
5032013-08-01MATTHEW WALTERS2020-12-21

Plan Statistics for WOODLANDS SENIOR LIVING, LLC EMPLOYEE GROUP DENTAL & VISION PLAN

401k plan membership statisitcs for WOODLANDS SENIOR LIVING, LLC EMPLOYEE GROUP DENTAL & VISION PLAN

Measure Date Value
2020: WOODLANDS SENIOR LIVING, LLC EMPLOYEE GROUP DENTAL & VISION PLAN 2020 401k membership
Total participants, beginning-of-year2020-04-01151
Total number of active participants reported on line 7a of the Form 55002020-04-010
Total of all active and inactive participants2020-04-010
2019: WOODLANDS SENIOR LIVING, LLC EMPLOYEE GROUP DENTAL & VISION PLAN 2019 401k membership
Total participants, beginning-of-year2019-04-01145
Total number of active participants reported on line 7a of the Form 55002019-04-01152
Total of all active and inactive participants2019-04-01152
2018: WOODLANDS SENIOR LIVING, LLC EMPLOYEE GROUP DENTAL & VISION PLAN 2018 401k membership
Total participants, beginning-of-year2018-04-01145
Total number of active participants reported on line 7a of the Form 55002018-04-01145
Total of all active and inactive participants2018-04-01145
2017: WOODLANDS SENIOR LIVING, LLC EMPLOYEE GROUP DENTAL & VISION PLAN 2017 401k membership
Total participants, beginning-of-year2017-04-01148
Total number of active participants reported on line 7a of the Form 55002017-04-01148
Total of all active and inactive participants2017-04-01148
2016: WOODLANDS SENIOR LIVING, LLC EMPLOYEE GROUP DENTAL & VISION PLAN 2016 401k membership
Total participants, beginning-of-year2016-08-01128
Total number of active participants reported on line 7a of the Form 55002016-08-01128
Total of all active and inactive participants2016-08-01128
Total participants2016-08-01128
2015: WOODLANDS SENIOR LIVING, LLC EMPLOYEE GROUP DENTAL & VISION PLAN 2015 401k membership
Total participants, beginning-of-year2015-08-01107
Total number of active participants reported on line 7a of the Form 55002015-08-01107
Total of all active and inactive participants2015-08-01107
2013: WOODLANDS SENIOR LIVING, LLC EMPLOYEE GROUP DENTAL & VISION PLAN 2013 401k membership
Total participants, beginning-of-year2013-08-01100
Total number of active participants reported on line 7a of the Form 55002013-08-01100
Total of all active and inactive participants2013-08-01100

Form 5500 Responses for WOODLANDS SENIOR LIVING, LLC EMPLOYEE GROUP DENTAL & VISION PLAN

2020: WOODLANDS SENIOR LIVING, LLC EMPLOYEE GROUP DENTAL & VISION PLAN 2020 form 5500 responses
2020-04-01Type of plan entitySingle employer plan
2020-04-01This submission is the final filingYes
2020-04-01Plan funding arrangement – InsuranceYes
2020-04-01Plan benefit arrangement – InsuranceYes
2019: WOODLANDS SENIOR LIVING, LLC EMPLOYEE GROUP DENTAL & VISION PLAN 2019 form 5500 responses
2019-04-01Type of plan entitySingle employer plan
2019-04-01Plan funding arrangement – InsuranceYes
2019-04-01Plan benefit arrangement – InsuranceYes
2018: WOODLANDS SENIOR LIVING, LLC EMPLOYEE GROUP DENTAL & VISION PLAN 2018 form 5500 responses
2018-04-01Type of plan entitySingle employer plan
2018-04-01Plan funding arrangement – InsuranceYes
2018-04-01Plan benefit arrangement – InsuranceYes
2017: WOODLANDS SENIOR LIVING, LLC EMPLOYEE GROUP DENTAL & VISION PLAN 2017 form 5500 responses
2017-04-01Type of plan entitySingle employer plan
2017-04-01Plan funding arrangement – InsuranceYes
2017-04-01Plan benefit arrangement – InsuranceYes
2016: WOODLANDS SENIOR LIVING, LLC EMPLOYEE GROUP DENTAL & VISION PLAN 2016 form 5500 responses
2016-08-01Type of plan entitySingle employer plan
2016-08-01Submission has been amendedNo
2016-08-01This submission is the final filingNo
2016-08-01This return/report is a short plan year return/report (less than 12 months)Yes
2016-08-01Plan is a collectively bargained planNo
2016-08-01Plan funding arrangement – InsuranceYes
2016-08-01Plan benefit arrangement – InsuranceYes
2015: WOODLANDS SENIOR LIVING, LLC EMPLOYEE GROUP DENTAL & VISION PLAN 2015 form 5500 responses
2015-08-01Type of plan entitySingle employer plan
2015-08-01Plan funding arrangement – InsuranceYes
2015-08-01Plan benefit arrangement – InsuranceYes
2013: WOODLANDS SENIOR LIVING, LLC EMPLOYEE GROUP DENTAL & VISION PLAN 2013 form 5500 responses
2013-08-01Type of plan entitySingle employer plan
2013-08-01First time form 5500 has been submittedYes
2013-08-01Plan funding arrangement – InsuranceYes
2013-08-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

DELTA DENTAL PLAN OF MAINE (National Association of Insurance Commissioners NAIC id number: 14369 )
Policy contract number000062130
Policy instance 2
Insurance contract or identification number000062130
Number of Individuals Covered180
Insurance policy start date2020-04-01
Insurance policy end date2021-03-31
Total amount of commissions paid to insurance brokerUSD $3,588
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $61,747
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,862
Insurance broker organization code?3
RED TREE INSURANCE COMPANY, INC. (National Association of Insurance Commissioners NAIC id number: 13646 )
Policy contract number000962130
Policy instance 1
Insurance contract or identification number000962130
Number of Individuals Covered142
Insurance policy start date2020-04-01
Insurance policy end date2021-03-31
Total amount of commissions paid to insurance brokerUSD $1,044
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $8,751
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $908
Insurance broker organization code?3
RED TREE INSURANCE COMPANY, INC. (National Association of Insurance Commissioners NAIC id number: 13646 )
Policy contract number000962130
Policy instance 1
Insurance contract or identification number000962130
Number of Individuals Covered196
Insurance policy start date2019-04-01
Insurance policy end date2020-03-31
Total amount of commissions paid to insurance brokerUSD $1,109
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $9,602
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $883
Insurance broker organization code?3
DELTA DENTAL PLAN OF MAINE (National Association of Insurance Commissioners NAIC id number: 14369 )
Policy contract number000062130
Policy instance 2
Insurance contract or identification number000062130
Number of Individuals Covered206
Insurance policy start date2019-04-01
Insurance policy end date2020-03-31
Total amount of commissions paid to insurance brokerUSD $3,580
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $56,776
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,347
Insurance broker organization code?3
RED TREE INSURANCE COMPANY, INC. (National Association of Insurance Commissioners NAIC id number: 13646 )
Policy contract number000962130
Policy instance 1
Insurance contract or identification number000962130
Number of Individuals Covered161
Insurance policy start date2018-04-01
Insurance policy end date2019-03-31
Total amount of commissions paid to insurance brokerUSD $1,062
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $9,221
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $139
Insurance broker organization code?3
DELTA DENTAL PLAN OF MAINE (National Association of Insurance Commissioners NAIC id number: 14369 )
Policy contract number000062130
Policy instance 2
Insurance contract or identification number000062130
Number of Individuals Covered196
Insurance policy start date2018-04-01
Insurance policy end date2019-03-31
Total amount of commissions paid to insurance brokerUSD $7,559
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $67,311
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,749
Insurance broker organization code?3
DELTA DENTAL PLAN OF MAINE (National Association of Insurance Commissioners NAIC id number: 14369 )
Policy contract number000062130
Policy instance 2
Insurance contract or identification number000062130
Number of Individuals Covered198
Insurance policy start date2017-04-01
Insurance policy end date2018-03-31
Total amount of commissions paid to insurance brokerUSD $7,488
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $72,606
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
RED TREE INSURANCE COMPANY, INC. (National Association of Insurance Commissioners NAIC id number: 13646 )
Policy contract number000962130
Policy instance 1
Insurance contract or identification number000962130
Number of Individuals Covered166
Insurance policy start date2017-04-01
Insurance policy end date2018-03-31
Total amount of commissions paid to insurance brokerUSD $970
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $9,223
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract number010-028480
Policy instance 1
Insurance contract or identification number010-028480
Number of Individuals Covered235
Insurance policy start date2015-08-01
Insurance policy end date2016-07-31
Total amount of commissions paid to insurance brokerUSD $5,889
Total amount of fees paid to insurance companyUSD $258
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $58,890
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,889
Amount paid for insurance broker fees258
Additional information about fees paid to insurance brokerADDITIONAL COMPENSATION
Insurance broker organization code?4
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract number010-028480
Policy instance 1
Insurance contract or identification number010-028480
Number of Individuals Covered220
Insurance policy start date2013-08-01
Insurance policy end date2014-07-31
Total amount of commissions paid to insurance brokerUSD $5,026
Total amount of fees paid to insurance companyUSD $463
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $50,257
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,026
Amount paid for insurance broker fees463
Additional information about fees paid to insurance brokerADDITIONAL COMPENSATION
Insurance broker organization code?3

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