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AYA HEALTHCARE, INC. WELFARE BENEFIT PLAN 401k Plan overview

Plan NameAYA HEALTHCARE, INC. WELFARE BENEFIT PLAN
Plan identification number 501

AYA HEALTHCARE, INC. WELFARE BENEFIT 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)
  • Other welfare benefit cover

401k Sponsoring company profile

AYA HEALTHCARE, INC. has sponsored the creation of one or more 401k plans.

Company Name:AYA HEALTHCARE, INC.
Employer identification number (EIN):270738500
NAIC Classification:561300

Form 5500 Filing Information

Submission information for form 5500 for 401k plan AYA HEALTHCARE, INC. WELFARE BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012021-12-01AMBER ZEEB2023-06-22
5012020-12-01AMBER ZEEB2022-06-30
5012019-12-01AMBER ZEEB2021-06-10
5012018-12-01AMBER ZEEB2020-04-08
5012017-12-01AMBER ZEEB2019-04-25

Plan Statistics for AYA HEALTHCARE, INC. WELFARE BENEFIT PLAN

401k plan membership statisitcs for AYA HEALTHCARE, INC. WELFARE BENEFIT PLAN

Measure Date Value
2021: AYA HEALTHCARE, INC. WELFARE BENEFIT PLAN 2021 401k membership
Total participants, beginning-of-year2021-12-0139,497
Total number of active participants reported on line 7a of the Form 55002021-12-0153,025
Number of retired or separated participants receiving benefits2021-12-01855
Number of other retired or separated participants entitled to future benefits2021-12-010
Total of all active and inactive participants2021-12-0153,880
Number of employers contributing to the scheme2021-12-010
2020: AYA HEALTHCARE, INC. WELFARE BENEFIT PLAN 2020 401k membership
Total participants, beginning-of-year2020-12-0115,086
Total number of active participants reported on line 7a of the Form 55002020-12-0138,769
Number of retired or separated participants receiving benefits2020-12-01728
Number of other retired or separated participants entitled to future benefits2020-12-010
Total of all active and inactive participants2020-12-0139,497
Number of employers contributing to the scheme2020-12-010
2019: AYA HEALTHCARE, INC. WELFARE BENEFIT PLAN 2019 401k membership
Total participants, beginning-of-year2019-12-015,967
Total number of active participants reported on line 7a of the Form 55002019-12-0112,825
Number of retired or separated participants receiving benefits2019-12-012,290
Number of other retired or separated participants entitled to future benefits2019-12-010
Total of all active and inactive participants2019-12-0115,115
Number of employers contributing to the scheme2019-12-010
2018: AYA HEALTHCARE, INC. WELFARE BENEFIT PLAN 2018 401k membership
Total participants, beginning-of-year2018-12-013,532
Total number of active participants reported on line 7a of the Form 55002018-12-014,514
Number of retired or separated participants receiving benefits2018-12-01175
Number of other retired or separated participants entitled to future benefits2018-12-010
Total of all active and inactive participants2018-12-014,689
Number of employers contributing to the scheme2018-12-010
2017: AYA HEALTHCARE, INC. WELFARE BENEFIT PLAN 2017 401k membership
Total participants, beginning-of-year2017-12-013,672
Total number of active participants reported on line 7a of the Form 55002017-12-013,532
Number of retired or separated participants receiving benefits2017-12-010
Number of other retired or separated participants entitled to future benefits2017-12-010
Total of all active and inactive participants2017-12-013,532
Number of employers contributing to the scheme2017-12-010

Form 5500 Responses for AYA HEALTHCARE, INC. WELFARE BENEFIT PLAN

2021: AYA HEALTHCARE, INC. WELFARE BENEFIT PLAN 2021 form 5500 responses
2021-12-01Type of plan entitySingle employer plan
2021-12-01Plan funding arrangement – InsuranceYes
2021-12-01Plan funding arrangement – General assets of the sponsorYes
2021-12-01Plan benefit arrangement – InsuranceYes
2021-12-01Plan benefit arrangement – General assets of the sponsorYes
2020: AYA HEALTHCARE, INC. WELFARE BENEFIT PLAN 2020 form 5500 responses
2020-12-01Type of plan entitySingle employer plan
2020-12-01Plan funding arrangement – InsuranceYes
2020-12-01Plan funding arrangement – General assets of the sponsorYes
2020-12-01Plan benefit arrangement – InsuranceYes
2020-12-01Plan benefit arrangement – General assets of the sponsorYes
2019: AYA HEALTHCARE, INC. WELFARE BENEFIT PLAN 2019 form 5500 responses
2019-12-01Type of plan entitySingle employer plan
2019-12-01Plan funding arrangement – InsuranceYes
2019-12-01Plan benefit arrangement – InsuranceYes
2018: AYA HEALTHCARE, INC. WELFARE BENEFIT PLAN 2018 form 5500 responses
2018-12-01Type of plan entitySingle employer plan
2018-12-01Plan funding arrangement – InsuranceYes
2018-12-01Plan benefit arrangement – InsuranceYes
2017: AYA HEALTHCARE, INC. WELFARE BENEFIT PLAN 2017 form 5500 responses
2017-12-01Type of plan entitySingle employer plan
2017-12-01Plan funding arrangement – InsuranceYes
2017-12-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number453573
Policy instance 1
Insurance contract or identification number453573
Number of Individuals Covered56331
Insurance policy start date2021-12-01
Insurance policy end date2022-11-30
Total amount of commissions paid to insurance brokerUSD $70,618
Total amount of fees paid to insurance companyUSD $20,149
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $1,153,147
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $70,618
Amount paid for insurance broker fees20149
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
UNITED HEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number1431115
Policy instance 5
Insurance contract or identification number1431115
Number of Individuals Covered53025
Insurance policy start date2021-12-01
Insurance policy end date2022-11-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedEMPLOYEE ASSISTANCE PROGRAM
Welfare Benefit Premiums Paid to CarrierUSD $238,051
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
HEALTH AND HUMAN RESOURCE CENTER, INC. (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number1431117
Policy instance 4
Insurance contract or identification number1431117
Number of Individuals Covered1142
Insurance policy start date2021-12-01
Insurance policy end date2022-11-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedEMPLOYEE ASSISTANCE PROGRAM
Welfare Benefit Premiums Paid to CarrierUSD $18,259
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number160978
Policy instance 3
Insurance contract or identification number160978
Number of Individuals Covered52781
Insurance policy start date2021-12-01
Insurance policy end date2022-11-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENT, HOSPITAL
Welfare Benefit Premiums Paid to CarrierUSD $262,192,263
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNIVERSITY HEALTH ALLIANCE (National Association of Insurance Commissioners NAIC id number: 47953 )
Policy contract number4881
Policy instance 2
Insurance contract or identification number4881
Number of Individuals Covered123
Insurance policy start date2021-12-01
Insurance policy end date2022-11-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $40,074
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number160978
Policy instance 3
Insurance contract or identification number160978
Number of Individuals Covered31861
Insurance policy start date2020-12-01
Insurance policy end date2021-11-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Other welfare benefits providedEMPLOYEE ASSISTANCE PROGRAM
Welfare Benefit Premiums Paid to CarrierUSD $113,012,859
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNIVERSITY HEALTH ALLIANCE (National Association of Insurance Commissioners NAIC id number: 47953 )
Policy contract number4881
Policy instance 2
Insurance contract or identification number4881
Number of Individuals Covered59
Insurance policy start date2020-12-01
Insurance policy end date2021-11-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $18,318
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number453573
Policy instance 1
Insurance contract or identification number453573
Number of Individuals Covered44264
Insurance policy start date2020-12-01
Insurance policy end date2021-11-30
Total amount of commissions paid to insurance brokerUSD $0
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 $824,735
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNIVERSITY HEALTH ALLIANCE (National Association of Insurance Commissioners NAIC id number: 47953 )
Policy contract number4881
Policy instance 3
Insurance contract or identification number4881
Number of Individuals Covered2
Insurance policy start date2019-12-01
Insurance policy end date2020-11-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $9,430
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number453573
Policy instance 2
Insurance contract or identification number453573
Number of Individuals Covered8493
Insurance policy start date2019-12-01
Insurance policy end date2020-11-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
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 $2,572,805
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CALIFORNIA PHYSICIANS SERVICE (National Association of Insurance Commissioners NAIC id number: 47732 )
Policy contract numberW0035638
Policy instance 1
Insurance contract or identification numberW0035638
Number of Individuals Covered9036
Insurance policy start date2019-12-01
Insurance policy end date2020-11-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $38,766,648
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNIVERSITY HEALTH ALLIANCE (National Association of Insurance Commissioners NAIC id number: 47953 )
Policy contract number4881
Policy instance 3
Insurance contract or identification number4881
Number of Individuals Covered22
Insurance policy start date2019-02-01
Insurance policy end date2019-11-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $80,647
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number453573
Policy instance 2
Insurance contract or identification number453573
Number of Individuals Covered4514
Insurance policy start date2018-12-01
Insurance policy end date2019-11-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
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 $2,231,961
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CALIFORNIA PHYSICIANS SERVICE (National Association of Insurance Commissioners NAIC id number: 47732 )
Policy contract numberW0035638
Policy instance 1
Insurance contract or identification numberW0035638
Number of Individuals Covered5650
Insurance policy start date2018-12-01
Insurance policy end date2019-11-30
Total amount of commissions paid to insurance brokerUSD $-26,932
Total amount of fees paid to insurance companyUSD $20,834
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $22,953,958
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $-26,932
Amount paid for insurance broker fees20834
Additional information about fees paid to insurance brokerBONUS OVERRIDE NON-MONETARY COMPENSATION
Insurance broker organization code?3
CALIFORNIA PHYSICIANS SERVICE (National Association of Insurance Commissioners NAIC id number: 47732 )
Policy contract numberW0035638
Policy instance 1
Insurance contract or identification numberW0035638
Number of Individuals Covered4482
Insurance policy start date2017-12-01
Insurance policy end date2018-11-30
Total amount of commissions paid to insurance brokerUSD $39,489
Total amount of fees paid to insurance companyUSD $627
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $17,999,139
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number453573
Policy instance 2
Insurance contract or identification number453573
Number of Individuals Covered3532
Insurance policy start date2017-12-01
Insurance policy end date2018-11-30
Total amount of commissions paid to insurance brokerUSD $341
Total amount of fees paid to insurance companyUSD $0
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 $704,973
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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