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ORLANDO CITY SC GROUP HEALTH PLAN 401k Plan overview

Plan NameORLANDO CITY SC GROUP HEALTH PLAN
Plan identification number 501

ORLANDO CITY SC GROUP HEALTH 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)

401k Sponsoring company profile

ORLANDO SPORTS HOLDINGS, LLC has sponsored the creation of one or more 401k plans.

Company Name:ORLANDO SPORTS HOLDINGS, LLC
Employer identification number (EIN):261550157
NAIC Classification:711210
NAIC Description: Spectator Sports

Additional information about ORLANDO SPORTS HOLDINGS, LLC

Jurisdiction of Incorporation: State of Delaware Division of Corporations
Incorporation Date:
Company Identification Number: 4464178

More information about ORLANDO SPORTS HOLDINGS, LLC

Form 5500 Filing Information

Submission information for form 5500 for 401k plan ORLANDO CITY SC GROUP HEALTH PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012022-05-01CARLOS OSORIO2023-11-09
5012021-05-01CARLOS OSORIO2022-11-21
5012020-05-01CARLOS OSORIO2021-12-03
5012019-05-01CARLOS ALFREDO OSORIO2021-02-08
5012018-05-01CARLOS ALFREDO OSORIO2019-12-05
5012017-05-01

Plan Statistics for ORLANDO CITY SC GROUP HEALTH PLAN

401k plan membership statisitcs for ORLANDO CITY SC GROUP HEALTH PLAN

Measure Date Value
2022: ORLANDO CITY SC GROUP HEALTH PLAN 2022 401k membership
Total participants, beginning-of-year2022-05-01160
Total number of active participants reported on line 7a of the Form 55002022-05-01198
Number of retired or separated participants receiving benefits2022-05-012
Number of other retired or separated participants entitled to future benefits2022-05-0110
Total of all active and inactive participants2022-05-01210
Number of employers contributing to the scheme2022-05-010
2021: ORLANDO CITY SC GROUP HEALTH PLAN 2021 401k membership
Total participants, beginning-of-year2021-05-01170
Total number of active participants reported on line 7a of the Form 55002021-05-01157
Number of retired or separated participants receiving benefits2021-05-016
Number of other retired or separated participants entitled to future benefits2021-05-015
Total of all active and inactive participants2021-05-01168
Number of employers contributing to the scheme2021-05-010
2020: ORLANDO CITY SC GROUP HEALTH PLAN 2020 401k membership
Total participants, beginning-of-year2020-05-01150
Total number of active participants reported on line 7a of the Form 55002020-05-01133
Number of retired or separated participants receiving benefits2020-05-012
Number of other retired or separated participants entitled to future benefits2020-05-010
Total of all active and inactive participants2020-05-01135
Number of employers contributing to the scheme2020-05-010
2019: ORLANDO CITY SC GROUP HEALTH PLAN 2019 401k membership
Total participants, beginning-of-year2019-05-01126
Total number of active participants reported on line 7a of the Form 55002019-05-01131
Number of retired or separated participants receiving benefits2019-05-010
Number of other retired or separated participants entitled to future benefits2019-05-010
Total of all active and inactive participants2019-05-01131
Number of employers contributing to the scheme2019-05-010
2018: ORLANDO CITY SC GROUP HEALTH PLAN 2018 401k membership
Total participants, beginning-of-year2018-05-01122
Total number of active participants reported on line 7a of the Form 55002018-05-01118
Number of retired or separated participants receiving benefits2018-05-013
Number of other retired or separated participants entitled to future benefits2018-05-010
Total of all active and inactive participants2018-05-01121
Number of employers contributing to the scheme2018-05-010
2017: ORLANDO CITY SC GROUP HEALTH PLAN 2017 401k membership
Total participants, beginning-of-year2017-05-01113
Total number of active participants reported on line 7a of the Form 55002017-05-01122
Number of retired or separated participants receiving benefits2017-05-013
Number of other retired or separated participants entitled to future benefits2017-05-010
Total of all active and inactive participants2017-05-01125
Number of employers contributing to the scheme2017-05-010

Form 5500 Responses for ORLANDO CITY SC GROUP HEALTH PLAN

2022: ORLANDO CITY SC GROUP HEALTH PLAN 2022 form 5500 responses
2022-05-01Type of plan entitySingle employer plan
2022-05-01Plan funding arrangement – InsuranceYes
2022-05-01Plan funding arrangement – General assets of the sponsorYes
2022-05-01Plan benefit arrangement – InsuranceYes
2022-05-01Plan benefit arrangement – General assets of the sponsorYes
2021: ORLANDO CITY SC GROUP HEALTH PLAN 2021 form 5500 responses
2021-05-01Type of plan entitySingle employer plan
2021-05-01Plan funding arrangement – InsuranceYes
2021-05-01Plan benefit arrangement – InsuranceYes
2020: ORLANDO CITY SC GROUP HEALTH PLAN 2020 form 5500 responses
2020-05-01Type of plan entitySingle employer plan
2020-05-01Plan funding arrangement – InsuranceYes
2020-05-01Plan benefit arrangement – InsuranceYes
2019: ORLANDO CITY SC GROUP HEALTH PLAN 2019 form 5500 responses
2019-05-01Type of plan entitySingle employer plan
2019-05-01Plan funding arrangement – InsuranceYes
2019-05-01Plan benefit arrangement – InsuranceYes
2018: ORLANDO CITY SC GROUP HEALTH PLAN 2018 form 5500 responses
2018-05-01Type of plan entitySingle employer plan
2018-05-01Plan funding arrangement – InsuranceYes
2018-05-01Plan benefit arrangement – InsuranceYes
2017: ORLANDO CITY SC GROUP HEALTH PLAN 2017 form 5500 responses
2017-05-01Type of plan entitySingle employer plan
2017-05-01First time form 5500 has been submittedYes
2017-05-01Plan funding arrangement – InsuranceYes
2017-05-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGLUG0BQL4
Policy instance 3
Insurance contract or identification numberGLUG0BQL4
Number of Individuals Covered198
Insurance policy start date2022-05-01
Insurance policy end date2023-04-30
Total amount of commissions paid to insurance brokerUSD $4,896
Total amount of fees paid to insurance companyUSD $1,419
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $32,637
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,896
Amount paid for insurance broker fees1419
Additional information about fees paid to insurance brokerOTHER COMPENSATION
Insurance broker organization code?3
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number149567
Policy instance 2
Insurance contract or identification number149567
Number of Individuals Covered284
Insurance policy start date2022-05-01
Insurance policy end date2023-04-30
Total amount of commissions paid to insurance brokerUSD $9,977
Total amount of fees paid to insurance companyUSD $55,986
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,182,932
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9,977
Amount paid for insurance broker fees55986
Additional information about fees paid to insurance brokerDIRECT COMPENSATION
Insurance broker organization code?3
NATIONAL GUARDIAN LIFE (National Association of Insurance Commissioners NAIC id number: 66583 )
Policy contract number39331
Policy instance 1
Insurance contract or identification number39331
Number of Individuals Covered135
Insurance policy start date2022-05-01
Insurance policy end date2023-04-30
Total amount of commissions paid to insurance brokerUSD $17
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $12,373
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $17
Amount paid for insurance broker fees0
Insurance broker organization code?3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGLUG0BQL4
Policy instance 3
Insurance contract or identification numberGLUG0BQL4
Number of Individuals Covered170
Insurance policy start date2021-05-01
Insurance policy end date2022-04-30
Total amount of commissions paid to insurance brokerUSD $7,545
Total amount of fees paid to insurance companyUSD $2,176
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $50,295
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,545
Amount paid for insurance broker fees2176
Additional information about fees paid to insurance brokerOTHER COMPENSATION
Insurance broker organization code?3
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number149567
Policy instance 2
Insurance contract or identification number149567
Number of Individuals Covered249
Insurance policy start date2021-05-01
Insurance policy end date2022-04-30
Total amount of commissions paid to insurance brokerUSD $8,178
Total amount of fees paid to insurance companyUSD $44,155
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $994,901
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,178
Amount paid for insurance broker fees44155
Additional information about fees paid to insurance brokerDIRECT COMPENSATION
Insurance broker organization code?3
NATIONAL GUARDIAN LIFE (National Association of Insurance Commissioners NAIC id number: 66583 )
Policy contract number39331
Policy instance 1
Insurance contract or identification number39331
Number of Individuals Covered137
Insurance policy start date2021-05-01
Insurance policy end date2022-04-30
Total amount of commissions paid to insurance brokerUSD $1,269
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $12,692
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,269
Amount paid for insurance broker fees0
Insurance broker organization code?3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGLUG0BQL4
Policy instance 3
Insurance contract or identification numberGLUG0BQL4
Number of Individuals Covered136
Insurance policy start date2020-05-01
Insurance policy end date2021-04-30
Total amount of commissions paid to insurance brokerUSD $7,554
Total amount of fees paid to insurance companyUSD $1,224
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $50,361
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,554
Amount paid for insurance broker fees1224
Additional information about fees paid to insurance brokerOTHER COMPENSATION
Insurance broker organization code?3
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number149567
Policy instance 2
Insurance contract or identification number149567
Number of Individuals Covered223
Insurance policy start date2020-05-01
Insurance policy end date2021-04-30
Total amount of commissions paid to insurance brokerUSD $13,094
Total amount of fees paid to insurance companyUSD $41,080
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $931,418
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $13,094
Amount paid for insurance broker fees41080
Additional information about fees paid to insurance brokerDIRECT COMPENSATION
Insurance broker organization code?3
NATIONAL GUARDIAN LIFE (National Association of Insurance Commissioners NAIC id number: 66583 )
Policy contract number39331
Policy instance 1
Insurance contract or identification number39331
Number of Individuals Covered128
Insurance policy start date2020-05-01
Insurance policy end date2021-04-30
Total amount of commissions paid to insurance brokerUSD $1,148
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $11,475
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,148
Amount paid for insurance broker fees0
Insurance broker organization code?3
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number9K9932
Policy instance 1
Insurance contract or identification number9K9932
Number of Individuals Covered266
Insurance policy start date2019-05-01
Insurance policy end date2020-04-30
Total amount of commissions paid to insurance brokerUSD $54,673
Total amount of fees paid to insurance companyUSD $6,948
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $1,070,617
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $54,673
Amount paid for insurance broker fees6948
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number9K9932
Policy instance 1
Insurance contract or identification number9K9932
Number of Individuals Covered241
Insurance policy start date2018-05-01
Insurance policy end date2019-04-30
Total amount of commissions paid to insurance brokerUSD $51,294
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $1,001,791
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $51,294
Amount paid for insurance broker fees0
Insurance broker organization code?3
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number571850
Policy instance 1
Insurance contract or identification number571850
Number of Individuals Covered225
Insurance policy start date2017-05-01
Insurance policy end date2018-04-30
Total amount of commissions paid to insurance brokerUSD $54,979
Total amount of fees paid to insurance companyUSD $2,310
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $1,015,061
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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