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MEDLEY PHARMACY LTD PLAN 401k Plan overview

Plan NameMEDLEY PHARMACY LTD PLAN
Plan identification number 502

MEDLEY PHARMACY LTD PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Long-term disability cover
  • Unfunded, fully insured, or combination unfunded/insured welfare plan that will not file a Form 5500 for next plan year pursuant to 29 CFR 2520.104-20.
  • Unfunded, fully insured, or combination unfunded/insured welfare plan that stopped filing form 5500s in an earlier plan year pursuant to 29 CFR 2520.104-20.

401k Sponsoring company profile

MEDLEY PHARMACY, INC. has sponsored the creation of one or more 401k plans.

Company Name:MEDLEY PHARMACY, INC.
Employer identification number (EIN):431236515
NAIC Classification:446110
NAIC Description:Pharmacies and Drug Stores

Form 5500 Filing Information

Submission information for form 5500 for 401k plan MEDLEY PHARMACY LTD PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5022021-12-01JARI DAWSON2023-03-30
5022020-12-01JARI DAWSON2022-05-31
5022019-12-01JARI DAWSON2021-05-11

Plan Statistics for MEDLEY PHARMACY LTD PLAN

401k plan membership statisitcs for MEDLEY PHARMACY LTD PLAN

Measure Date Value
2021: MEDLEY PHARMACY LTD PLAN 2021 401k membership
Total participants, beginning-of-year2021-12-01105
Total number of active participants reported on line 7a of the Form 55002021-12-01106
Number of retired or separated participants receiving benefits2021-12-010
Number of other retired or separated participants entitled to future benefits2021-12-010
Total of all active and inactive participants2021-12-01106
Number of employers contributing to the scheme2021-12-010
2020: MEDLEY PHARMACY LTD PLAN 2020 401k membership
Total participants, beginning-of-year2020-12-01101
Total number of active participants reported on line 7a of the Form 55002020-12-0191
Number of retired or separated participants receiving benefits2020-12-010
Number of other retired or separated participants entitled to future benefits2020-12-015
Total of all active and inactive participants2020-12-0196
Number of employers contributing to the scheme2020-12-010
2019: MEDLEY PHARMACY LTD PLAN 2019 401k membership
Total participants, beginning-of-year2019-12-01108
Total number of active participants reported on line 7a of the Form 55002019-12-01113
Number of retired or separated participants receiving benefits2019-12-010
Number of other retired or separated participants entitled to future benefits2019-12-010
Total of all active and inactive participants2019-12-01113
Number of employers contributing to the scheme2019-12-010

Form 5500 Responses for MEDLEY PHARMACY LTD PLAN

2021: MEDLEY PHARMACY LTD PLAN 2021 form 5500 responses
2021-12-01Type of plan entitySingle employer plan
2021-12-01Plan funding arrangement – InsuranceYes
2021-12-01Plan benefit arrangement – InsuranceYes
2020: MEDLEY PHARMACY LTD PLAN 2020 form 5500 responses
2020-12-01Type of plan entitySingle employer plan
2020-12-01Plan funding arrangement – InsuranceYes
2020-12-01Plan benefit arrangement – InsuranceYes
2019: MEDLEY PHARMACY LTD PLAN 2019 form 5500 responses
2019-12-01Type of plan entitySingle employer plan
2019-12-01First time form 5500 has been submittedYes
2019-12-01Plan funding arrangement – InsuranceYes
2019-12-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

ANTHEM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61069 )
Policy contract numberCM10000525
Policy instance 1
Insurance contract or identification numberCM10000525
Number of Individuals Covered106
Insurance policy start date2021-12-01
Insurance policy end date2022-11-30
Total amount of commissions paid to insurance brokerUSD $2,109
Total amount of fees paid to insurance companyUSD $142
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $13,485
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,109
Amount paid for insurance broker fees142
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
ANTHEM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61069 )
Policy contract numberCM10000525
Policy instance 1
Insurance contract or identification numberCM10000525
Number of Individuals Covered105
Insurance policy start date2020-12-01
Insurance policy end date2021-11-30
Total amount of commissions paid to insurance brokerUSD $1,821
Total amount of fees paid to insurance companyUSD $701
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $13,900
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,821
Amount paid for insurance broker fees701
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number10260197
Policy instance 1
Insurance contract or identification number10260197
Number of Individuals Covered111
Insurance policy start date2019-12-01
Insurance policy end date2020-11-30
Total amount of commissions paid to insurance brokerUSD $2,436
Total amount of fees paid to insurance companyUSD $1,099
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $16,857
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,436
Amount paid for insurance broker fees720
Additional information about fees paid to insurance brokerBROKER BONUS
Insurance broker organization code?3

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