401k Plan data: OHIO MASONIC HOME LONG TERM DISABILITY PLAN plan

OHIO MASONIC HOME LONG TERM DISABILITY PLAN 401k Plan overview

Plan Name	OHIO MASONIC HOME LONG TERM DISABILITY PLAN
Plan identification number	503

OHIO MASONIC HOME LONG TERM DISABILITY PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Life insurance Dental Long-term disability cover Death benefits (include travel accident but not life insurance) Other welfare benefit cover

401k Sponsoring company profile

THE OHIO MASONIC HOME has sponsored the creation of one or more 401k plans.

Company Name: THE OHIO MASONIC HOME

Employer identification number (EIN): 310536997

NAIC Classification: 623000
NAIC Description: Nursing and Residential Care Facilities

Additional information about THE OHIO MASONIC HOME

Jurisdiction of Incorporation: Ohio Secretary of State Business Services Division

Incorporation Date: 1890-02-25

Company Identification Number: 7260

Legal Registered Office Address: 2655 W. NATIONAL ROAD
-
SPRINGFIELD
United States of America (USA)
45504

More information about THE OHIO MASONIC HOME

Form 5500 Filing Information

Submission information for form 5500 for 401k plan OHIO MASONIC HOME LONG TERM DISABILITY PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
503 2020-01-01 AMY GORDON 2021-07-15
503 2020-01-01
503 2020-01-01 BROOKE HERRING
503 2019-01-01 AMY GORDON 2020-08-27
503 2018-01-01 LARA BENTLEY 2019-10-07
503 2017-01-01
503 2016-01-01 LARA BENTLEY LARA BENTLEY 2017-07-27
503 2015-01-01 LARA BENTLEY LARA BENTLEY 2016-09-26
503 2014-01-01 LARA BENTLEY LARA BENTLEY 2015-07-06
503 2013-01-01 LARA BENTLEY LARA BENTLEY 2014-06-26
503 2012-01-01 LARA BENTLEY LARA BENTLEY 2013-09-16
503 2011-09-01 LARA BENTLEY LARA BENTLEY 2012-07-31
503 2010-09-01 LARA BENTLEY
503 2009-09-01 LARA BENTLEY

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
503	2020-01-01	AMY GORDON	2021-07-15
503	2020-01-01
503	2020-01-01	BROOKE HERRING
503	2019-01-01	AMY GORDON	2020-08-27
503	2018-01-01	LARA BENTLEY	2019-10-07
503	2017-01-01
503	2016-01-01	LARA BENTLEY		LARA BENTLEY	2017-07-27
503	2015-01-01	LARA BENTLEY		LARA BENTLEY	2016-09-26
503	2014-01-01	LARA BENTLEY		LARA BENTLEY	2015-07-06
503	2013-01-01	LARA BENTLEY		LARA BENTLEY	2014-06-26
503	2012-01-01	LARA BENTLEY		LARA BENTLEY	2013-09-16
503	2011-09-01	LARA BENTLEY		LARA BENTLEY	2012-07-31
503	2010-09-01	LARA BENTLEY
503	2009-09-01	LARA BENTLEY

Plan Statistics for OHIO MASONIC HOME LONG TERM DISABILITY PLAN

401k plan membership statisitcs for OHIO MASONIC HOME LONG TERM DISABILITY PLAN

Measure Date Value
2020: OHIO MASONIC HOME LONG TERM DISABILITY PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 349
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 385
Number of retired or separated participants receiving benefits 2020-01-01 0
Number of other retired or separated participants entitled to future benefits 2020-01-01 0
Total of all active and inactive participants 2020-01-01 385
Number of employers contributing to the scheme 2020-01-01 0
2019: OHIO MASONIC HOME LONG TERM DISABILITY PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 351
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 349
Number of retired or separated participants receiving benefits 2019-01-01 0
Number of other retired or separated participants entitled to future benefits 2019-01-01 0
Total of all active and inactive participants 2019-01-01 349
Number of employers contributing to the scheme 2019-01-01 0
2018: OHIO MASONIC HOME LONG TERM DISABILITY PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 351
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 351
Number of retired or separated participants receiving benefits 2018-01-01 0
Number of other retired or separated participants entitled to future benefits 2018-01-01 0
Total of all active and inactive participants 2018-01-01 351
Number of employers contributing to the scheme 2018-01-01 0
2017: OHIO MASONIC HOME LONG TERM DISABILITY PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 372
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 351
Number of retired or separated participants receiving benefits 2017-01-01 0
Number of other retired or separated participants entitled to future benefits 2017-01-01 0
Total of all active and inactive participants 2017-01-01 351
2016: OHIO MASONIC HOME LONG TERM DISABILITY PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 425
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 372
Total of all active and inactive participants 2016-01-01 372
2015: OHIO MASONIC HOME LONG TERM DISABILITY PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 408
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 425
Total of all active and inactive participants 2015-01-01 425
2014: OHIO MASONIC HOME LONG TERM DISABILITY PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 408
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 408
Total of all active and inactive participants 2014-01-01 408
2013: OHIO MASONIC HOME LONG TERM DISABILITY PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 396
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 408
Total of all active and inactive participants 2013-01-01 408
2012: OHIO MASONIC HOME LONG TERM DISABILITY PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 379
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 396
Total of all active and inactive participants 2012-01-01 396
2011: OHIO MASONIC HOME LONG TERM DISABILITY PLAN 2011 401k membership
Total participants, beginning-of-year 2011-09-01 413
Total number of active participants reported on line 7a of the Form 5500 2011-09-01 379
Total of all active and inactive participants 2011-09-01 379
2010: OHIO MASONIC HOME LONG TERM DISABILITY PLAN 2010 401k membership
Total participants, beginning-of-year 2010-09-01 366
Total number of active participants reported on line 7a of the Form 5500 2010-09-01 409
Number of retired or separated participants receiving benefits 2010-09-01 4
Number of other retired or separated participants entitled to future benefits 2010-09-01 0
Total of all active and inactive participants 2010-09-01 413
2009: OHIO MASONIC HOME LONG TERM DISABILITY PLAN 2009 401k membership
Total participants, beginning-of-year 2009-09-01 401
Total number of active participants reported on line 7a of the Form 5500 2009-09-01 362
Number of retired or separated participants receiving benefits 2009-09-01 4
Number of other retired or separated participants entitled to future benefits 2009-09-01 0
Total of all active and inactive participants 2009-09-01 366

Measure	Date	Value
2020: OHIO MASONIC HOME LONG TERM DISABILITY PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	349
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	385
Number of retired or separated participants receiving benefits	2020-01-01	0
Number of other retired or separated participants entitled to future benefits	2020-01-01	0
Total of all active and inactive participants	2020-01-01	385
Number of employers contributing to the scheme	2020-01-01	0
2019: OHIO MASONIC HOME LONG TERM DISABILITY PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	351
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	349
Number of retired or separated participants receiving benefits	2019-01-01	0
Number of other retired or separated participants entitled to future benefits	2019-01-01	0
Total of all active and inactive participants	2019-01-01	349
Number of employers contributing to the scheme	2019-01-01	0
2018: OHIO MASONIC HOME LONG TERM DISABILITY PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	351
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	351
Number of retired or separated participants receiving benefits	2018-01-01	0
Number of other retired or separated participants entitled to future benefits	2018-01-01	0
Total of all active and inactive participants	2018-01-01	351
Number of employers contributing to the scheme	2018-01-01	0
2017: OHIO MASONIC HOME LONG TERM DISABILITY PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	372
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	351
Number of retired or separated participants receiving benefits	2017-01-01	0
Number of other retired or separated participants entitled to future benefits	2017-01-01	0
Total of all active and inactive participants	2017-01-01	351
2016: OHIO MASONIC HOME LONG TERM DISABILITY PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	425
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	372
Total of all active and inactive participants	2016-01-01	372
2015: OHIO MASONIC HOME LONG TERM DISABILITY PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	408
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	425
Total of all active and inactive participants	2015-01-01	425
2014: OHIO MASONIC HOME LONG TERM DISABILITY PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	408
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	408
Total of all active and inactive participants	2014-01-01	408
2013: OHIO MASONIC HOME LONG TERM DISABILITY PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	396
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	408
Total of all active and inactive participants	2013-01-01	408
2012: OHIO MASONIC HOME LONG TERM DISABILITY PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	379
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	396
Total of all active and inactive participants	2012-01-01	396
2011: OHIO MASONIC HOME LONG TERM DISABILITY PLAN 2011 401k membership
Total participants, beginning-of-year	2011-09-01	413
Total number of active participants reported on line 7a of the Form 5500	2011-09-01	379
Total of all active and inactive participants	2011-09-01	379
2010: OHIO MASONIC HOME LONG TERM DISABILITY PLAN 2010 401k membership
Total participants, beginning-of-year	2010-09-01	366
Total number of active participants reported on line 7a of the Form 5500	2010-09-01	409
Number of retired or separated participants receiving benefits	2010-09-01	4
Number of other retired or separated participants entitled to future benefits	2010-09-01	0
Total of all active and inactive participants	2010-09-01	413
2009: OHIO MASONIC HOME LONG TERM DISABILITY PLAN 2009 401k membership
Total participants, beginning-of-year	2009-09-01	401
Total number of active participants reported on line 7a of the Form 5500	2009-09-01	362
Number of retired or separated participants receiving benefits	2009-09-01	4
Number of other retired or separated participants entitled to future benefits	2009-09-01	0
Total of all active and inactive participants	2009-09-01	366

Form 5500 Responses for OHIO MASONIC HOME LONG TERM DISABILITY PLAN

2020: OHIO MASONIC HOME LONG TERM DISABILITY PLAN 2020 form 5500 responses
2020-01-01	Type of plan entity	Single employer plan
2020-01-01	Submission has been amended	Yes
2020-01-01	This submission is the final filing	Yes
2020-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2020-01-01	Plan is a collectively bargained plan	No
2020-01-01	Plan funding arrangement – Insurance	Yes
2020-01-01	Plan benefit arrangement – Insurance	Yes
2019: OHIO MASONIC HOME LONG TERM DISABILITY PLAN 2019 form 5500 responses
2019-01-01	Type of plan entity	Single employer plan
2019-01-01	Plan funding arrangement – Insurance	Yes
2019-01-01	Plan benefit arrangement – Insurance	Yes
2018: OHIO MASONIC HOME LONG TERM DISABILITY PLAN 2018 form 5500 responses
2018-01-01	Type of plan entity	Single employer plan
2018-01-01	Plan funding arrangement – Insurance	Yes
2018-01-01	Plan benefit arrangement – Insurance	Yes
2017: OHIO MASONIC HOME LONG TERM DISABILITY PLAN 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	Plan funding arrangement – Insurance	Yes
2017-01-01	Plan benefit arrangement – Insurance	Yes
2016: OHIO MASONIC HOME LONG TERM DISABILITY PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Submission has been amended	No
2016-01-01	This submission is the final filing	No
2016-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-01-01	Plan is a collectively bargained plan	No
2016-01-01	Plan funding arrangement – Insurance	Yes
2016-01-01	Plan benefit arrangement – Insurance	Yes
2015: OHIO MASONIC HOME LONG TERM DISABILITY PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Submission has been amended	No
2015-01-01	This submission is the final filing	No
2015-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-01-01	Plan is a collectively bargained plan	No
2015-01-01	Plan funding arrangement – Insurance	Yes
2015-01-01	Plan benefit arrangement – Insurance	Yes
2014: OHIO MASONIC HOME LONG TERM DISABILITY PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Submission has been amended	No
2014-01-01	This submission is the final filing	No
2014-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-01-01	Plan is a collectively bargained plan	No
2014-01-01	Plan funding arrangement – Insurance	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes
2013: OHIO MASONIC HOME LONG TERM DISABILITY PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Submission has been amended	No
2013-01-01	This submission is the final filing	No
2013-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-01-01	Plan is a collectively bargained plan	No
2013-01-01	Plan funding arrangement – Insurance	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2012: OHIO MASONIC HOME LONG TERM DISABILITY PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Submission has been amended	No
2012-01-01	This submission is the final filing	No
2012-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-01-01	Plan is a collectively bargained plan	No
2012-01-01	Plan funding arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2011: OHIO MASONIC HOME LONG TERM DISABILITY PLAN 2011 form 5500 responses
2011-09-01	Type of plan entity	Single employer plan
2011-09-01	Submission has been amended	No
2011-09-01	This submission is the final filing	No
2011-09-01	This return/report is a short plan year return/report (less than 12 months)	Yes
2011-09-01	Plan is a collectively bargained plan	No
2011-09-01	Plan funding arrangement – Insurance	Yes
2011-09-01	Plan benefit arrangement – Insurance	Yes
2010: OHIO MASONIC HOME LONG TERM DISABILITY PLAN 2010 form 5500 responses
2010-09-01	Type of plan entity	Single employer plan
2010-09-01	Submission has been amended	No
2010-09-01	This submission is the final filing	No
2010-09-01	This return/report is a short plan year return/report (less than 12 months)	No
2010-09-01	Plan is a collectively bargained plan	No
2010-09-01	Plan funding arrangement – Insurance	Yes
2010-09-01	Plan benefit arrangement – Insurance	Yes
2009: OHIO MASONIC HOME LONG TERM DISABILITY PLAN 2009 form 5500 responses
2009-09-01	Type of plan entity	Single employer plan
2009-09-01	Submission has been amended	No
2009-09-01	This submission is the final filing	No
2009-09-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-09-01	Plan is a collectively bargained plan	No
2009-09-01	Plan funding arrangement – Insurance	Yes
2009-09-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )

Policy contract number

5955569

Policy instance

Insurance contract or identification number	5955569
Number of Individuals Covered	385
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $31
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	Yes
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Welfare Benefit Premiums Paid to Carrier	USD $93,862
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )

Policy contract number

TM05955569

Policy instance

PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )

Policy contract number

16096

Policy instance

PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )

Policy contract number

16096

Policy instance

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Company Name:	THE OHIO MASONIC HOME
Employer identification number (EIN):	310536997
NAIC Classification:	623000
NAIC Description:	Nursing and Residential Care Facilities

Jurisdiction of Incorporation:	Ohio Secretary of State Business Services Division
Incorporation Date:	1890-02-25
Company Identification Number:	7260
Legal Registered Office Address:	2655 W. NATIONAL ROAD - SPRINGFIELD United States of America (USA) 45504