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| Plan Name | PHM SERVICES, INC. GROUP LIFE & DISABILITY PLAN |
| Plan identification number | 502 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | QUIPT HOME MEDICAL |
| Employer identification number (EIN): | 384005391 |
| NAIC Classification: | 621399 |
| NAIC Description: | Offices of All Other Miscellaneous Health Practitioners |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 502 | 2019-10-01 | KIMBERLY CHILDERS | 2021-07-13 |
| Measure | Date | Value |
|---|---|---|
| 2019: PHM SERVICES, INC. GROUP LIFE & DISABILITY PLAN 2019 401k membership | ||
| Total participants, beginning-of-year | 2019-10-01 | 115 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-10-01 | 0 |
| Total of all active and inactive participants | 2019-10-01 | 0 |
| 2019: PHM SERVICES, INC. GROUP LIFE & DISABILITY PLAN 2019 form 5500 responses | ||
|---|---|---|
| 2019-10-01 | Type of plan entity | Single employer plan |
| 2019-10-01 | First time form 5500 has been submitted | Yes |
| 2019-10-01 | This submission is the final filing | Yes |
| 2019-10-01 | Plan funding arrangement – Insurance | Yes |
| 2019-10-01 | Plan benefit arrangement – Insurance | Yes |
| AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 ) | |||||||||||||||||||||||||||
| Policy contract number | G 00615561 | ||||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||||
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