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ERB OPCO SAV, LLC DBA ST. ANDREWS VILLAGE 401k Plan overview

Plan NameERB OPCO SAV, LLC DBA ST. ANDREWS VILLAGE
Plan identification number 503

ERB OPCO SAV, LLC DBA ST. ANDREWS VILLAGE Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Dental
  • Vision

401k Sponsoring company profile

ERB OPCO SAV, LLC has sponsored the creation of one or more 401k plans.

Company Name:ERB OPCO SAV, LLC
Employer identification number (EIN):453088464
NAIC Classification:623000
NAIC Description: Nursing and Residential Care Facilities

Additional information about ERB OPCO SAV, LLC

Jurisdiction of Incorporation: State of Delaware Division of Corporations
Incorporation Date:
Company Identification Number: 5029682

More information about ERB OPCO SAV, LLC

Form 5500 Filing Information

Submission information for form 5500 for 401k plan ERB OPCO SAV, LLC DBA ST. ANDREWS VILLAGE

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5032016-05-01CINDY CLARK
5032015-05-01CINDY CLARK
5032014-05-01
5032013-05-01
5032012-05-01BRIAN E. DOWD
5032011-05-01TERRY FRISBY

Plan Statistics for ERB OPCO SAV, LLC DBA ST. ANDREWS VILLAGE

401k plan membership statisitcs for ERB OPCO SAV, LLC DBA ST. ANDREWS VILLAGE

Measure Date Value
2016: ERB OPCO SAV, LLC DBA ST. ANDREWS VILLAGE 2016 401k membership
Total participants, beginning-of-year2016-05-01168
Total number of active participants reported on line 7a of the Form 55002016-05-01146
Number of retired or separated participants receiving benefits2016-05-010
Number of other retired or separated participants entitled to future benefits2016-05-010
Total of all active and inactive participants2016-05-01146
2015: ERB OPCO SAV, LLC DBA ST. ANDREWS VILLAGE 2015 401k membership
Total participants, beginning-of-year2015-05-01169
Total number of active participants reported on line 7a of the Form 55002015-05-01168
Number of retired or separated participants receiving benefits2015-05-010
Number of other retired or separated participants entitled to future benefits2015-05-010
Total of all active and inactive participants2015-05-01168
2014: ERB OPCO SAV, LLC DBA ST. ANDREWS VILLAGE 2014 401k membership
Total participants, beginning-of-year2014-05-01161
Total number of active participants reported on line 7a of the Form 55002014-05-01169
Total of all active and inactive participants2014-05-01169
2013: ERB OPCO SAV, LLC DBA ST. ANDREWS VILLAGE 2013 401k membership
Total participants, beginning-of-year2013-05-01148
Total number of active participants reported on line 7a of the Form 55002013-05-01161
Total of all active and inactive participants2013-05-01161
2012: ERB OPCO SAV, LLC DBA ST. ANDREWS VILLAGE 2012 401k membership
Total participants, beginning-of-year2012-05-0173
Total number of active participants reported on line 7a of the Form 55002012-05-01148
Total of all active and inactive participants2012-05-01148
2011: ERB OPCO SAV, LLC DBA ST. ANDREWS VILLAGE 2011 401k membership
Total participants, beginning-of-year2011-05-0186
Total number of active participants reported on line 7a of the Form 55002011-05-0186
Number of retired or separated participants receiving benefits2011-05-010
Number of other retired or separated participants entitled to future benefits2011-05-010
Total of all active and inactive participants2011-05-0186

Form 5500 Responses for ERB OPCO SAV, LLC DBA ST. ANDREWS VILLAGE

2016: ERB OPCO SAV, LLC DBA ST. ANDREWS VILLAGE 2016 form 5500 responses
2016-05-01Type of plan entitySingle employer plan
2016-05-01Plan funding arrangement – InsuranceYes
2016-05-01Plan benefit arrangement – InsuranceYes
2015: ERB OPCO SAV, LLC DBA ST. ANDREWS VILLAGE 2015 form 5500 responses
2015-05-01Type of plan entitySingle employer plan
2015-05-01Plan funding arrangement – InsuranceYes
2015-05-01Plan benefit arrangement – InsuranceYes
2014: ERB OPCO SAV, LLC DBA ST. ANDREWS VILLAGE 2014 form 5500 responses
2014-05-01Type of plan entitySingle employer plan
2014-05-01Plan funding arrangement – InsuranceYes
2014-05-01Plan benefit arrangement – InsuranceYes
2013: ERB OPCO SAV, LLC DBA ST. ANDREWS VILLAGE 2013 form 5500 responses
2013-05-01Type of plan entitySingle employer plan
2013-05-01Plan funding arrangement – InsuranceYes
2013-05-01Plan benefit arrangement – InsuranceYes
2012: ERB OPCO SAV, LLC DBA ST. ANDREWS VILLAGE 2012 form 5500 responses
2012-05-01Type of plan entitySingle employer plan
2012-05-01Plan funding arrangement – InsuranceYes
2012-05-01Plan benefit arrangement – InsuranceYes
2011: ERB OPCO SAV, LLC DBA ST. ANDREWS VILLAGE 2011 form 5500 responses
2011-05-01Type of plan entitySingle employer plan
2011-05-01Submission has been amendedNo
2011-05-01This submission is the final filingNo
2011-05-01This return/report is a short plan year return/report (less than 12 months)No
2011-05-01Plan is a collectively bargained planNo
2011-05-01Plan funding arrangement – InsuranceYes
2011-05-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

DELTA DENTAL OF TENNESSEE (National Association of Insurance Commissioners NAIC id number: 54526 )
Policy contract number5776
Policy instance 1
Insurance contract or identification number5776
Number of Individuals Covered168
Insurance policy start date2015-05-01
Insurance policy end date2016-04-30
Total amount of commissions paid to insurance brokerUSD $6,304
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,304
Additional information about fees paid to insurance brokerCOMMISSIONS
Insurance broker organization code?3
Insurance broker nameBROWN & BROWN OF FL
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number30032755
Policy instance 2
Insurance contract or identification number30032755
Number of Individuals Covered105
Insurance policy start date2015-05-01
Insurance policy end date2016-04-30
Total amount of commissions paid to insurance brokerUSD $735
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $9,700
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $735
Additional information about fees paid to insurance brokerCOMMISSIONS
Insurance broker organization code?3
Insurance broker nameBROWN & BROWN OF FLORIDA INC.
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number30032755
Policy instance 2
Insurance contract or identification number30032755
Number of Individuals Covered104
Insurance policy start date2014-05-01
Insurance policy end date2015-04-30
Total amount of commissions paid to insurance brokerUSD $703
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $9,069
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $703
Insurance broker organization code?3
Insurance broker nameBROWN & BROWN OF FLORIDA
DELTA DENTAL OF TENNESSEE (National Association of Insurance Commissioners NAIC id number: 54526 )
Policy contract number5776
Policy instance 1
Insurance contract or identification number5776
Number of Individuals Covered169
Insurance policy start date2014-05-01
Insurance policy end date2015-04-30
Total amount of commissions paid to insurance brokerUSD $5,171
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,171
Insurance broker organization code?3
Insurance broker nameBROWN & BROWN OF FLORIDA
DELTA DENTAL OF TENNESSEE (National Association of Insurance Commissioners NAIC id number: 54526 )
Policy contract number5776
Policy instance 1
Insurance contract or identification number5776
Number of Individuals Covered161
Insurance policy start date2013-05-01
Insurance policy end date2014-04-30
Total amount of commissions paid to insurance brokerUSD $321
Total amount of fees paid to insurance companyUSD $5,286
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $321
Amount paid for insurance broker fees5286
Insurance broker organization code?3
Insurance broker nameBROWN & BROWN OF FLORIDA
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number30032755
Policy instance 2
Insurance contract or identification number30032755
Number of Individuals Covered96
Insurance policy start date2013-05-01
Insurance policy end date2014-04-30
Total amount of commissions paid to insurance brokerUSD $646
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $7,924
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $646
Insurance broker organization code?3
Insurance broker nameBROWN & BROWN OF FLORIDA
DELTA DENTAL OF TENNESSEE (National Association of Insurance Commissioners NAIC id number: 54526 )
Policy contract number5776
Policy instance 1
Insurance contract or identification number5776
Number of Individuals Covered148
Insurance policy start date2012-05-01
Insurance policy end date2013-04-30
Total amount of commissions paid to insurance brokerUSD $4,247
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,877
Insurance broker organization code?3
Insurance broker nameBROWN & BROWN OF FL
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number30032755
Policy instance 2
Insurance contract or identification number30032755
Number of Individuals Covered66
Insurance policy start date2012-05-01
Insurance policy end date2013-04-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $7,609
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00447291
Policy instance 1
Insurance contract or identification number00447291
Number of Individuals Covered86
Insurance policy start date2011-05-01
Insurance policy end date2012-04-30
Total amount of commissions paid to insurance brokerUSD $3,904
Total amount of fees paid to insurance companyUSD $2,628
Are there contracts with allocated funds for individual policies?No
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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 CarrierUSD $50,410
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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