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ISAIAH HOUSE BASIC LIFE PLAN 401k Plan overview

Plan NameISAIAH HOUSE BASIC LIFE PLAN
Plan identification number 501

ISAIAH HOUSE BASIC LIFE 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

ISAIAH HOUSE, INC. has sponsored the creation of one or more 401k plans.

Company Name:ISAIAH HOUSE, INC.
Employer identification number (EIN):262961334
NAIC Classification:621420
NAIC Description:Outpatient Mental Health and Substance Abuse Centers

Additional information about ISAIAH HOUSE, INC.

Jurisdiction of Incorporation: New York Department of State
Incorporation Date: 2000-03-06
Company Identification Number: 2481674
Legal Registered Office Address: 71 PRINCE STREET
Monroe
ROCHESTER
United States of America (USA)
14605

More information about ISAIAH HOUSE, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan ISAIAH HOUSE BASIC LIFE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012021-06-01JENNIFER HAMILTON2022-09-22
5012020-06-01MISSY PRICE2022-02-08
5012019-06-01APRIL ROTH2020-11-02

Plan Statistics for ISAIAH HOUSE BASIC LIFE PLAN

401k plan membership statisitcs for ISAIAH HOUSE BASIC LIFE PLAN

Measure Date Value
2021: ISAIAH HOUSE BASIC LIFE PLAN 2021 401k membership
Total participants, beginning-of-year2021-06-01193
Total number of active participants reported on line 7a of the Form 55002021-06-01351
Number of retired or separated participants receiving benefits2021-06-010
Number of other retired or separated participants entitled to future benefits2021-06-010
Total of all active and inactive participants2021-06-01351
Number of employers contributing to the scheme2021-06-010
2020: ISAIAH HOUSE BASIC LIFE PLAN 2020 401k membership
Total participants, beginning-of-year2020-06-01127
Total number of active participants reported on line 7a of the Form 55002020-06-01193
Number of retired or separated participants receiving benefits2020-06-010
Number of other retired or separated participants entitled to future benefits2020-06-010
Total of all active and inactive participants2020-06-01193
Number of employers contributing to the scheme2020-06-010
2019: ISAIAH HOUSE BASIC LIFE PLAN 2019 401k membership
Total participants, beginning-of-year2019-06-01100
Total number of active participants reported on line 7a of the Form 55002019-06-01127
Number of retired or separated participants receiving benefits2019-06-010
Number of other retired or separated participants entitled to future benefits2019-06-010
Total of all active and inactive participants2019-06-01127
Number of employers contributing to the scheme2019-06-010

Form 5500 Responses for ISAIAH HOUSE BASIC LIFE PLAN

2021: ISAIAH HOUSE BASIC LIFE PLAN 2021 form 5500 responses
2021-06-01Type of plan entitySingle employer plan
2021-06-01Plan funding arrangement – InsuranceYes
2021-06-01Plan benefit arrangement – InsuranceYes
2020: ISAIAH HOUSE BASIC LIFE PLAN 2020 form 5500 responses
2020-06-01Type of plan entitySingle employer plan
2020-06-01Plan funding arrangement – InsuranceYes
2020-06-01Plan benefit arrangement – InsuranceYes
2019: ISAIAH HOUSE BASIC LIFE PLAN 2019 form 5500 responses
2019-06-01Type of plan entitySingle employer plan
2019-06-01First time form 5500 has been submittedYes
2019-06-01Plan funding arrangement – InsuranceYes
2019-06-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

HUMANA INSURANCE COMPANY OF KENTUCKY INC (National Association of Insurance Commissioners NAIC id number: 60219 )
Policy contract number863229
Policy instance 1
Insurance contract or identification number863229
Number of Individuals Covered351
Insurance policy start date2021-06-01
Insurance policy end date2022-05-31
Total amount of commissions paid to insurance brokerUSD $5,414
Total amount of fees paid to insurance companyUSD $2,142
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $40,944
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,414
Amount paid for insurance broker fees0
Insurance broker organization code?3
Additional information about fees paid to insurance brokerBONUS
COMPBENEFITS (National Association of Insurance Commissioners NAIC id number: 54739 )
Policy contract number863229
Policy instance 2
Insurance contract or identification number863229
Number of Individuals Covered145
Insurance policy start date2021-06-01
Insurance policy end date2022-05-31
Total amount of commissions paid to insurance brokerUSD $3,814
Total amount of fees paid to insurance companyUSD $3,266
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $59,898
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,814
Amount paid for insurance broker fees0
Insurance broker organization code?3
Additional information about fees paid to insurance brokerBONUS
HUMANA HEALTH PLAN, INC. (National Association of Insurance Commissioners NAIC id number: 95885 )
Policy contract number863229
Policy instance 3
Insurance contract or identification number863229
Number of Individuals Covered120
Insurance policy start date2021-06-01
Insurance policy end date2022-05-31
Total amount of commissions paid to insurance brokerUSD $22,050
Total amount of fees paid to insurance companyUSD $5,691
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $767,756
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $22,050
Amount paid for insurance broker fees0
Insurance broker organization code?3
Additional information about fees paid to insurance brokerBONUS
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number21886
Policy instance 4
Insurance contract or identification number21886
Number of Individuals Covered121
Insurance policy start date2021-06-01
Insurance policy end date2022-05-31
Total amount of commissions paid to insurance brokerUSD $8,846
Total amount of fees paid to insurance companyUSD $1,652
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENT, CRITICAL ILLNESS
Welfare Benefit Premiums Paid to CarrierUSD $63,313
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,846
Amount paid for insurance broker fees1652
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
HUMANA INSURANCE COMPANY OF KENTUCKY INC (National Association of Insurance Commissioners NAIC id number: 60219 )
Policy contract number863229
Policy instance 1
Insurance contract or identification number863229
Number of Individuals Covered193
Insurance policy start date2020-06-01
Insurance policy end date2021-05-31
Total amount of commissions paid to insurance brokerUSD $4,127
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $25,622
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,462
Amount paid for insurance broker fees0
Insurance broker organization code?3
COMPBENEFITS (National Association of Insurance Commissioners NAIC id number: 54739 )
Policy contract number863229
Policy instance 2
Insurance contract or identification number863229
Number of Individuals Covered102
Insurance policy start date2020-06-01
Insurance policy end date2021-05-31
Total amount of commissions paid to insurance brokerUSD $4,752
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $43,445
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,148
Amount paid for insurance broker fees0
Insurance broker organization code?3
HUMANA HEALTH PLAN, INC. (National Association of Insurance Commissioners NAIC id number: 95885 )
Policy contract number863229
Policy instance 3
Insurance contract or identification number863229
Number of Individuals Covered93
Insurance policy start date2020-06-01
Insurance policy end date2021-05-31
Total amount of commissions paid to insurance brokerUSD $17,928
Total amount of fees paid to insurance companyUSD $4,797
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $509,938
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $16,092
Amount paid for insurance broker fees4797
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number548656
Policy instance 1
Insurance contract or identification number548656
Number of Individuals Covered127
Insurance policy start date2019-06-01
Insurance policy end date2020-05-31
Total amount of commissions paid to insurance brokerUSD $3,833
Total amount of fees paid to insurance companyUSD $1,439
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $25,487
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,833
Amount paid for insurance broker fees1439
Insurance broker organization code?3

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