401k Plan data: LIFESPACE COMMUNITIES, INC EMPLOYEE LIFE AND DISABILITY BENEFIT PROGRAM WITH METLIFE plan

LIFESPACE COMMUNITIES, INC EMPLOYEE LIFE AND DISABILITY BENEFIT PROGRAM WITH METLIFE 401k Plan overview

Plan Name	LIFESPACE COMMUNITIES, INC EMPLOYEE LIFE AND DISABILITY BENEFIT PROGRAM WITH METLIFE
Plan identification number	509

LIFESPACE COMMUNITIES, INC EMPLOYEE LIFE AND DISABILITY BENEFIT PROGRAM WITH METLIFE Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Life insurance Temporary disability (accident and sickness) Long-term disability cover Other welfare benefit cover

401k Sponsoring company profile

LIFESPACE COMMUNITIES has sponsored the creation of one or more 401k plans.

Company Name: LIFESPACE COMMUNITIES

Employer identification number (EIN): 421068850

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

Additional information about LIFESPACE COMMUNITIES

Jurisdiction of Incorporation: Iowa Secretary of State Business Entities

Incorporation Date: 1976-08-05

Company Identification Number: 060160

Legal Registered Office Address: 400 E COURT AVE

DES MOINES
United States of America (USA)
50309

More information about LIFESPACE COMMUNITIES

Form 5500 Filing Information

Submission information for form 5500 for 401k plan LIFESPACE COMMUNITIES, INC EMPLOYEE LIFE AND DISABILITY BENEFIT PROGRAM WITH METLIFE

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
509 2022-04-01

Plan Statistics for LIFESPACE COMMUNITIES, INC EMPLOYEE LIFE AND DISABILITY BENEFIT PROGRAM WITH METLIFE

401k plan membership statisitcs for LIFESPACE COMMUNITIES, INC EMPLOYEE LIFE AND DISABILITY BENEFIT PROGRAM WITH METLIFE

Measure Date Value
2022: LIFESPACE COMMUNITIES, INC EMPLOYEE LIFE AND DISABILITY BENEFIT PROGRAM WITH METLIFE 2022 401k membership
Total participants, beginning-of-year 2022-04-01 2,582
Total number of active participants reported on line 7a of the Form 5500 2022-04-01 2,685
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 2,685

Measure	Date	Value
2022: LIFESPACE COMMUNITIES, INC EMPLOYEE LIFE AND DISABILITY BENEFIT PROGRAM WITH METLIFE 2022 401k membership
Total participants, beginning-of-year	2022-04-01	2,582
Total number of active participants reported on line 7a of the Form 5500	2022-04-01	2,685
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	2,685

Form 5500 Responses for LIFESPACE COMMUNITIES, INC EMPLOYEE LIFE AND DISABILITY BENEFIT PROGRAM WITH METLIFE

2022: LIFESPACE COMMUNITIES, INC EMPLOYEE LIFE AND DISABILITY BENEFIT PROGRAM WITH METLIFE 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	Submission has been amended	Yes
2022-04-01	This submission is the final filing	Yes
2022-04-01	This return/report is a short plan year return/report (less than 12 months)	Yes
2022-04-01	Plan is a collectively bargained plan	No
2022-04-01	Plan funding arrangement – General assets of the sponsor	Yes
2022-04-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

METROP0LITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )

Policy contract number

230084

Policy instance

Insurance contract or identification number	230084
Number of Individuals Covered	2685
Insurance policy start date	2022-04-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $102,990
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Unemployment Insurance Welfare Benefit	No
Other welfare benefits provided	CRITICAL ILLNESS INSURANCE, ACCIDENT INSURANCE
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 $872,004
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $102,990
Amount paid for insurance broker fees	0
Additional information about fees paid to insurance broker	BROKER
Insurance broker organization code?	3

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Company Name:	LIFESPACE COMMUNITIES
Employer identification number (EIN):	421068850
NAIC Classification:	623000
NAIC Description:	Nursing and Residential Care Facilities

Jurisdiction of Incorporation:	Iowa Secretary of State Business Entities
Incorporation Date:	1976-08-05
Company Identification Number:	060160
Legal Registered Office Address:	400 E COURT AVE DES MOINES United States of America (USA) 50309