401k Plan data: IRELAND HOME-BASED SERVICES, LLC EMPLOYEE BENEFIT PLAN plan

IRELAND HOME-BASED SERVICES, LLC EMPLOYEE BENEFIT PLAN 401k Plan overview

Plan Name	IRELAND HOME-BASED SERVICES, LLC EMPLOYEE BENEFIT PLAN
Plan identification number	510

IRELAND HOME-BASED SERVICES, LLC EMPLOYEE BENEFIT PLAN Benefits

401k Plan Type	Welfare 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

401k Sponsoring company profile

IRELAND HOME-BASED SERVICES, LLC has sponsored the creation of one or more 401k plans.

Company Name: IRELAND HOME-BASED SERVICES, LLC

Employer identification number (EIN): 202729113

NAIC Classification: 621610
NAIC Description: Home Health Care Services

Form 5500 Filing Information

Submission information for form 5500 for 401k plan IRELAND HOME-BASED SERVICES, LLC EMPLOYEE BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
510 2023-02-01 GARY EMMONS 2024-10-01
510 2022-02-01 GARY EMMONS 2023-08-10
510 2021-02-01 GARY EMMONS 2022-05-10
510 2020-02-01 GARY EMMONS 2021-05-07
510 2020-02-01 GARY EMMONS 2021-08-30
510 2019-02-01
510 2018-02-01 LINDSEY ROBAK LINDSEY ROBAK 2019-05-09

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
510	2023-02-01	GARY EMMONS	2024-10-01
510	2022-02-01	GARY EMMONS	2023-08-10
510	2021-02-01	GARY EMMONS	2022-05-10
510	2020-02-01	GARY EMMONS	2021-05-07
510	2020-02-01	GARY EMMONS	2021-08-30
510	2019-02-01
510	2018-02-01	LINDSEY ROBAK		LINDSEY ROBAK	2019-05-09

Form 5500 Responses for IRELAND HOME-BASED SERVICES, LLC EMPLOYEE BENEFIT PLAN

2023: IRELAND HOME-BASED SERVICES, LLC EMPLOYEE BENEFIT PLAN 2023 form 5500 responses
2023-02-01	Type of plan entity	Single employer plan
2023-02-01	Plan funding arrangement – Insurance	Yes
2023-02-01	Plan funding arrangement – General assets of the sponsor	Yes
2023-02-01	Plan benefit arrangement – Insurance	Yes
2023-02-01	Plan benefit arrangement – General assets of the sponsor	Yes
2022: IRELAND HOME-BASED SERVICES, LLC EMPLOYEE BENEFIT PLAN 2022 form 5500 responses
2022-02-01	Type of plan entity	Single employer plan
2022-02-01	Plan funding arrangement – Insurance	Yes
2022-02-01	Plan funding arrangement – General assets of the sponsor	Yes
2022-02-01	Plan benefit arrangement – Insurance	Yes
2022-02-01	Plan benefit arrangement – General assets of the sponsor	Yes
2021: IRELAND HOME-BASED SERVICES, LLC EMPLOYEE BENEFIT PLAN 2021 form 5500 responses
2021-02-01	Type of plan entity	Single employer plan
2021-02-01	Plan funding arrangement – Insurance	Yes
2021-02-01	Plan funding arrangement – General assets of the sponsor	Yes
2021-02-01	Plan benefit arrangement – Insurance	Yes
2021-02-01	Plan benefit arrangement – General assets of the sponsor	Yes
2020: IRELAND HOME-BASED SERVICES, LLC EMPLOYEE BENEFIT PLAN 2020 form 5500 responses
2020-02-01	Type of plan entity	Single employer plan
2020-02-01	Submission has been amended	Yes
2020-02-01	Plan funding arrangement – Insurance	Yes
2020-02-01	Plan funding arrangement – General assets of the sponsor	Yes
2020-02-01	Plan benefit arrangement – Insurance	Yes
2020-02-01	Plan benefit arrangement – General assets of the sponsor	Yes
2019: IRELAND HOME-BASED SERVICES, LLC EMPLOYEE BENEFIT PLAN 2019 form 5500 responses
2019-02-01	Type of plan entity	Single employer plan
2019-02-01	Submission has been amended	No
2019-02-01	This submission is the final filing	No
2019-02-01	This return/report is a short plan year return/report (less than 12 months)	No
2019-02-01	Plan is a collectively bargained plan	No
2019-02-01	Plan funding arrangement – Insurance	Yes
2019-02-01	Plan funding arrangement – General assets of the sponsor	Yes
2019-02-01	Plan benefit arrangement – Insurance	Yes
2019-02-01	Plan benefit arrangement – General assets of the sponsor	Yes
2018: IRELAND HOME-BASED SERVICES, LLC EMPLOYEE BENEFIT PLAN 2018 form 5500 responses
2018-02-01	Type of plan entity	Single employer plan
2018-02-01	First time form 5500 has been submitted	Yes
2018-02-01	Submission has been amended	No
2018-02-01	This submission is the final filing	No
2018-02-01	This return/report is a short plan year return/report (less than 12 months)	No
2018-02-01	Plan is a collectively bargained plan	No
2018-02-01	Plan funding arrangement – Insurance	Yes
2018-02-01	Plan funding arrangement – General assets of the sponsor	Yes
2018-02-01	Plan benefit arrangement – Insurance	Yes
2018-02-01	Plan benefit arrangement – General assets of the sponsor	Yes

Insurance Providers Used on plan

HEALTH RESOURCES INC (National Association of Insurance Commissioners NAIC id number: 96887 )

Policy contract number

804933240510

Policy instance

Insurance contract or identification number	804933240510
Number of Individuals Covered	225
Insurance policy start date	2023-02-01
Insurance policy end date	2024-01-31
Total amount of commissions paid to insurance broker	USD $2,418
Total amount of fees paid to insurance company	USD $0
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Welfare Benefit Premiums Paid to Carrier	USD $60,580
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )

Policy contract number

GL160572

Policy instance

Insurance contract or identification number	GL160572
Number of Individuals Covered	299
Insurance policy start date	2023-02-01
Insurance policy end date	2024-01-31
Total amount of commissions paid to insurance broker	USD $19,765
Total amount of fees paid to insurance company	USD $2,059
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	Yes
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Unemployment Insurance Welfare Benefit	No
Other welfare benefits provided	ACCIDENT,ACCIDENTAL DEATH AND DISMEMBERMENT,HOSPITAL
Welfare Benefit Premiums Paid to Carrier	USD $116,649
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	Yes

HEALTH RESOURCES INC (National Association of Insurance Commissioners NAIC id number: 96887 )

Policy contract number

804933240510

Policy instance

Insurance contract or identification number	804933240510
Number of Individuals Covered	256
Insurance policy start date	2022-02-01
Insurance policy end date	2023-01-31
Total amount of commissions paid to insurance broker	USD $2,760
Total amount of fees paid to insurance company	USD $0
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Welfare Benefit Premiums Paid to Carrier	USD $69,293
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )

Policy contract number

GL152321

Policy instance

Insurance contract or identification number	GL152321
Number of Individuals Covered	268
Insurance policy start date	2022-02-01
Insurance policy end date	2023-01-31
Total amount of commissions paid to insurance broker	USD $19,286
Total amount of fees paid to insurance company	USD $895
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	Yes
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Unemployment Insurance Welfare Benefit	No
Other welfare benefits provided	ACCIDENT,ACCIDENTAL DEATH AND DISMEMBERMENT,HOSPITAL
Welfare Benefit Premiums Paid to Carrier	USD $116,140
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

HEALTH RESOURCES INC (National Association of Insurance Commissioners NAIC id number: 96887 )

Policy contract number

804933240510

Policy instance

RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )

Policy contract number

GL152321

Policy instance

RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )

Policy contract number

136-009182

Policy instance

RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )

Policy contract number

GL152321

Policy instance

HEALTH RESOURCES INC (National Association of Insurance Commissioners NAIC id number: 96887 )

Policy contract number

804933240510

Policy instance

HEALTH RESOURCES INC (National Association of Insurance Commissioners NAIC id number: 96887 )

Policy contract number

804933240510

Policy instance

RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )

Policy contract number

GL152321

Policy instance

HEALTH RESOURCES INC (National Association of Insurance Commissioners NAIC id number: 96887 )

Policy contract number

804946430510

Policy instance

RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )

Policy contract number

VG 184184

Policy instance

RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )

Policy contract number

136-009182

Policy instance

HEALTH RESOURCES INC (National Association of Insurance Commissioners NAIC id number: 96887 )

Policy contract number

804933240510

Policy instance

RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )

Policy contract number

VPL 301972

Policy instance

RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )

Policy contract number

GL 152321

Policy instance

RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )

Policy contract number

VAI 825425

Policy instance

RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )

Policy contract number

VPS 326440

Policy instance

RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )

Policy contract number

GL 160572

Policy instance

RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )

Policy contract number

VAI 825425

Policy instance

RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )

Policy contract number

GL 152321

Policy instance

RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )

Policy contract number

VPL 301972

Policy instance

HEALTH RESOURCES INC (National Association of Insurance Commissioners NAIC id number: 96887 )

Policy contract number

804933240510

Policy instance

RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )

Policy contract number

136-009182

Policy instance

RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )

Policy contract number

VG 184184

Policy instance

HEALTH RESOURCES INC (National Association of Insurance Commissioners NAIC id number: 96887 )

Policy contract number

804946430510

Policy instance

RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )

Policy contract number

VPS 326440

Policy instance

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Company Name:	IRELAND HOME-BASED SERVICES, LLC
Employer identification number (EIN):	202729113
NAIC Classification:	621610
NAIC Description:	Home Health Care Services