401k Plan data: EBELS FAMILY CENTER'S GROUP INSURANCE PLAN plan

EBELS FAMILY CENTER'S GROUP INSURANCE PLAN 401k Plan overview

Plan Name	EBELS FAMILY CENTER'S GROUP INSURANCE PLAN
Plan identification number	510

EBELS FAMILY CENTER'S GROUP INSURANCE 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) Death benefits (include travel accident but not life insurance) Other welfare benefit cover

401k Sponsoring company profile

EBELS FAMILY CENTER, INC. has sponsored the creation of one or more 401k plans.

Company Name: EBELS FAMILY CENTER, INC.

Employer identification number (EIN): 382196500

NAIC Classification: 722300
NAIC Description: Special Food Services

Additional information about EBELS FAMILY CENTER, INC.

Jurisdiction of Incorporation: Michigan Secretary of State

Incorporation Date: 0000-00-00

Company Identification Number: 137318

Legal Registered Office Address: 420 E. PROSPER FALMOUTH

United States of America (USA)
49632

More information about EBELS FAMILY CENTER, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan EBELS FAMILY CENTER'S GROUP INSURANCE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
510 2022-04-01 JANET BENTLEY 2023-10-03

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
510	2022-04-01	JANET BENTLEY	2023-10-03

Plan Statistics for EBELS FAMILY CENTER'S GROUP INSURANCE PLAN

401k plan membership statisitcs for EBELS FAMILY CENTER'S GROUP INSURANCE PLAN

Measure Date Value
2022: EBELS FAMILY CENTER'S GROUP INSURANCE PLAN 2022 401k membership
Total participants, beginning-of-year 2022-04-01 104
Total number of active participants reported on line 7a of the Form 5500 2022-04-01 126
Number of retired or separated participants receiving benefits 2022-04-01 0
Number of other retired or separated participants entitled to future benefits 2022-04-01 0
Total of all active and inactive participants 2022-04-01 126
Number of employers contributing to the scheme 2022-04-01 0

Measure	Date	Value
2022: EBELS FAMILY CENTER'S GROUP INSURANCE PLAN 2022 401k membership
Total participants, beginning-of-year	2022-04-01	104
Total number of active participants reported on line 7a of the Form 5500	2022-04-01	126
Number of retired or separated participants receiving benefits	2022-04-01	0
Number of other retired or separated participants entitled to future benefits	2022-04-01	0
Total of all active and inactive participants	2022-04-01	126
Number of employers contributing to the scheme	2022-04-01	0

Form 5500 Responses for EBELS FAMILY CENTER'S GROUP INSURANCE PLAN

2022: EBELS FAMILY CENTER'S GROUP INSURANCE PLAN 2022 form 5500 responses
2022-04-01	Type of plan entity	Single employer plan
2022-04-01	First time form 5500 has been submitted	Yes
2022-04-01	Plan funding arrangement – Insurance	Yes
2022-04-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

PRIORITY HEALTH (National Association of Insurance Commissioners NAIC id number: 95561 )

Policy contract number

774385 S001

Policy instance

Insurance contract or identification number	774385 S001
Number of Individuals Covered	56
Insurance policy start date	2022-04-01
Insurance policy end date	2023-03-31
Total amount of commissions paid to insurance broker	USD $8,526
Total amount of fees paid to insurance company	USD $0
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $284,197
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $8,526
Amount paid for insurance broker fees	0
Insurance broker organization code?	3

DELTA DENTAL OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54305 )

Policy contract number

10309

Policy instance

Insurance contract or identification number	10309
Number of Individuals Covered	133
Insurance policy start date	2022-04-01
Insurance policy end date	2023-03-31
Total amount of commissions paid to insurance broker	USD $4,173
Total amount of fees paid to insurance company	USD $0
Dental Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $4,173
Amount paid for insurance broker fees	0
Insurance broker organization code?	3

EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )

Policy contract number

1016368

Policy instance

Insurance contract or identification number	1016368
Number of Individuals Covered	134
Insurance policy start date	2022-04-01
Insurance policy end date	2023-03-31
Total amount of commissions paid to insurance broker	USD $809
Total amount of fees paid to insurance company	USD $0
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $8,054
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $809
Amount paid for insurance broker fees	0
Insurance broker organization code?	3

MONY (National Association of Insurance Commissioners NAIC id number: 78077 )

Policy contract number

009780

Policy instance

Insurance contract or identification number	009780
Number of Individuals Covered	127
Insurance policy start date	2022-04-01
Insurance policy end date	2023-03-31
Total amount of commissions paid to insurance broker	USD $6,852
Total amount of fees paid to insurance company	USD $0
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	Yes
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT, EMPLOYEE ASSISTANCE PROGRAM, ACCIDENT, CRITICAL ILLNESS
Welfare Benefit Premiums Paid to Carrier	USD $49,489
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $6,852
Amount paid for insurance broker fees	0
Insurance broker organization code?	3

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Company Name:	EBELS FAMILY CENTER, INC.
Employer identification number (EIN):	382196500
NAIC Classification:	722300
NAIC Description:	Special Food Services

Jurisdiction of Incorporation:	Michigan Secretary of State
Incorporation Date:	0000-00-00
Company Identification Number:	137318
Legal Registered Office Address:	420 E. PROSPER FALMOUTH United States of America (USA) 49632