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TUFTS HEALTH MEDICAL PLAN 401k Plan overview

Plan NameTUFTS HEALTH MEDICAL PLAN
Plan identification number 501

TUFTS HEALTH MEDICAL PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Death benefits (include travel accident but not life insurance)
  • 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

THE HOLIDAY RETIREMENT HOME INC. has sponsored the creation of one or more 401k plans.

Company Name:THE HOLIDAY RETIREMENT HOME INC.
Employer identification number (EIN):060878516
NAIC Classification:623000
NAIC Description: Nursing and Residential Care Facilities

Form 5500 Filing Information

Submission information for form 5500 for 401k plan TUFTS HEALTH MEDICAL PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012021-01-01JEFFREY ROY2023-04-11
5012020-01-01JEFFREY ROY2021-06-17
5012019-01-01JEFFREY ROY2020-04-13
5012018-01-01
5012017-01-01
5012016-01-01JEFFREY ROY
5012015-01-01JEFFREY ROY

Plan Statistics for TUFTS HEALTH MEDICAL PLAN

401k plan membership statisitcs for TUFTS HEALTH MEDICAL PLAN

Measure Date Value
2021: TUFTS HEALTH MEDICAL PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-01101
Total number of active participants reported on line 7a of the Form 55002021-01-0186
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 participants2021-01-0186
Number of employers contributing to the scheme2021-01-010
2020: TUFTS HEALTH MEDICAL PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-01129
Total number of active participants reported on line 7a of the Form 55002020-01-01135
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 participants2020-01-01135
Number of employers contributing to the scheme2020-01-010
2019: TUFTS HEALTH MEDICAL PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-01130
Total number of active participants reported on line 7a of the Form 55002019-01-01129
Number of retired or separated participants receiving benefits2019-01-011
Number of other retired or separated participants entitled to future benefits2019-01-010
Total of all active and inactive participants2019-01-01130
Number of employers contributing to the scheme2019-01-010
2018: TUFTS HEALTH MEDICAL PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-01129
Total number of active participants reported on line 7a of the Form 55002018-01-01129
Number of retired or separated participants receiving benefits2018-01-012
Number of other retired or separated participants entitled to future benefits2018-01-010
Total of all active and inactive participants2018-01-01131
Number of employers contributing to the scheme2018-01-010
2017: TUFTS HEALTH MEDICAL PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-01145
Total number of active participants reported on line 7a of the Form 55002017-01-01139
Number of retired or separated participants receiving benefits2017-01-011
Number of other retired or separated participants entitled to future benefits2017-01-010
Total of all active and inactive participants2017-01-01140
2016: TUFTS HEALTH MEDICAL PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-01225
Total number of active participants reported on line 7a of the Form 55002016-01-01223
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 participants2016-01-01223
2015: TUFTS HEALTH MEDICAL PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-01100
Total number of active participants reported on line 7a of the Form 55002015-01-01145
Number of retired or separated participants receiving benefits2015-01-010
Number of other retired or separated participants entitled to future benefits2015-01-010
Total of all active and inactive participants2015-01-01145

Form 5500 Responses for TUFTS HEALTH MEDICAL PLAN

2021: TUFTS HEALTH MEDICAL 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: TUFTS HEALTH MEDICAL PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan benefit arrangement – InsuranceYes
2019: TUFTS HEALTH MEDICAL PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan benefit arrangement – InsuranceYes
2018: TUFTS HEALTH MEDICAL PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan benefit arrangement – InsuranceYes
2017: TUFTS HEALTH MEDICAL PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan benefit arrangement – InsuranceYes
2016: TUFTS HEALTH MEDICAL 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 benefit arrangement – InsuranceYes
2015: TUFTS HEALTH MEDICAL PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Submission has been amendedNo
2015-01-01This submission is the final filingNo
2015-01-01This return/report is a short plan year return/report (less than 12 months)No
2015-01-01Plan is a collectively bargained planNo
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGLUG0BDQR
Policy instance 1
DELTA DENTAL OF RHODE ISLAND (National Association of Insurance Commissioners NAIC id number: 55301 )
Policy contract number3723-1
Policy instance 3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGLUG0BDQR
Policy instance 2
TUFTS ASSOCIATED HEALTH MAINTENANCE ORG., INC. (National Association of Insurance Commissioners NAIC id number: 95688 )
Policy contract number34581000
Policy instance 1
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGLUG0BDQR
Policy instance 3
DELTA DENTAL OF RHODE ISLAND (National Association of Insurance Commissioners NAIC id number: 55301 )
Policy contract number3723-1
Policy instance 2
TUFTS ASSOCIATED HEALTH MAINTENANCE ORG., INC. (National Association of Insurance Commissioners NAIC id number: 95688 )
Policy contract number34581000
Policy instance 1
BOSTON MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61476 )
Policy contract numberG25851
Policy instance 3
DELTA DENTAL OF RHODE ISLAND (National Association of Insurance Commissioners NAIC id number: 55301 )
Policy contract number3723-1
Policy instance 2
TUFTS ASSOCIATED HEALTH MAINTENANCE ORG., INC. (National Association of Insurance Commissioners NAIC id number: 95688 )
Policy contract number34581000
Policy instance 1
BOSTON MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61476 )
Policy contract numberG25851
Policy instance 3
DELTA DENTAL OF RHODE ISLAND (National Association of Insurance Commissioners NAIC id number: 55301 )
Policy contract number3723-1
Policy instance 2
TUFTS ASSOCIATED HEALTH MAINTENANCE ORG., INC. (National Association of Insurance Commissioners NAIC id number: 95688 )
Policy contract number34581000
Policy instance 1
TUFTS ASSOCIATED HEALTH MAINTENANCE ORG., INC. (National Association of Insurance Commissioners NAIC id number: 95688 )
Policy contract number38451/38452
Policy instance 3
BOSTON MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61476 )
Policy contract numberG25851
Policy instance 2
DELTA DENTAL OF RHODE ISLAND (National Association of Insurance Commissioners NAIC id number: 55301 )
Policy contract number37231
Policy instance 1

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