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CENTRALCARE INCORPORATED WELFARE PLAN 401k Plan overview

Plan NameCENTRALCARE INCORPORATED WELFARE PLAN
Plan identification number 501

CENTRALCARE INCORPORATED WELFARE PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Vision
  • Temporary disability (accident and sickness)
  • Long-term disability cover
  • Death benefits (include travel accident but not life insurance)
  • 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

CENTRALCARE, INCORPORATED has sponsored the creation of one or more 401k plans.

Company Name:CENTRALCARE, INCORPORATED
Employer identification number (EIN):541939041
NAIC Classification:238900

Additional information about CENTRALCARE, INCORPORATED

Jurisdiction of Incorporation: Virginia Secretary of State
Incorporation Date: 1999-04-09
Company Identification Number: 0519296
Legal Registered Office Address: 277 S. WASHINGTON STREET

ALEXANDRIA
United States of America (USA)
22314

More information about CENTRALCARE, INCORPORATED

Form 5500 Filing Information

Submission information for form 5500 for 401k plan CENTRALCARE INCORPORATED WELFARE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012019-03-01KRYSTLE OKOYE2020-08-13
5012019-03-01KRYSTLE OKOYE2022-02-15
5012018-03-01KRYSTLE OKOYE2019-11-06
5012017-08-01
5012016-08-01
5012016-08-01JUANITA THORNE2018-05-15

Plan Statistics for CENTRALCARE INCORPORATED WELFARE PLAN

401k plan membership statisitcs for CENTRALCARE INCORPORATED WELFARE PLAN

Measure Date Value
2019: CENTRALCARE INCORPORATED WELFARE PLAN 2019 401k membership
Total participants, beginning-of-year2019-03-01201
Total number of active participants reported on line 7a of the Form 55002019-03-01105
Number of retired or separated participants receiving benefits2019-03-010
Number of other retired or separated participants entitled to future benefits2019-03-010
Total of all active and inactive participants2019-03-01105
Number of employers contributing to the scheme2019-03-010
2018: CENTRALCARE INCORPORATED WELFARE PLAN 2018 401k membership
Total participants, beginning-of-year2018-03-01334
Total number of active participants reported on line 7a of the Form 55002018-03-0188
Number of retired or separated participants receiving benefits2018-03-013
Number of other retired or separated participants entitled to future benefits2018-03-010
Total of all active and inactive participants2018-03-0191
Number of employers contributing to the scheme2018-03-010
2017: CENTRALCARE INCORPORATED WELFARE PLAN 2017 401k membership
Total participants, beginning-of-year2017-08-01299
Total number of active participants reported on line 7a of the Form 55002017-08-01342
Number of retired or separated participants receiving benefits2017-08-010
Number of other retired or separated participants entitled to future benefits2017-08-010
Total of all active and inactive participants2017-08-01342
2016: CENTRALCARE INCORPORATED WELFARE PLAN 2016 401k membership
Total participants, beginning-of-year2016-08-01423
Total number of active participants reported on line 7a of the Form 55002016-08-01262
Number of retired or separated participants receiving benefits2016-08-010
Number of other retired or separated participants entitled to future benefits2016-08-010
Total of all active and inactive participants2016-08-01262

Form 5500 Responses for CENTRALCARE INCORPORATED WELFARE PLAN

2019: CENTRALCARE INCORPORATED WELFARE PLAN 2019 form 5500 responses
2019-03-01Type of plan entitySingle employer plan
2019-03-01Submission has been amendedYes
2019-03-01Plan funding arrangement – InsuranceYes
2019-03-01Plan benefit arrangement – InsuranceYes
2018: CENTRALCARE INCORPORATED WELFARE PLAN 2018 form 5500 responses
2018-03-01Type of plan entitySingle employer plan
2018-03-01Plan funding arrangement – InsuranceYes
2018-03-01Plan benefit arrangement – InsuranceYes
2017: CENTRALCARE INCORPORATED WELFARE PLAN 2017 form 5500 responses
2017-08-01Type of plan entitySingle employer plan
2017-08-01This return/report is a short plan year return/report (less than 12 months)Yes
2017-08-01Plan funding arrangement – InsuranceYes
2017-08-01Plan benefit arrangement – InsuranceYes
2016: CENTRALCARE INCORPORATED WELFARE PLAN 2016 form 5500 responses
2016-08-01Type of plan entitySingle employer plan
2016-08-01Submission has been amendedYes
2016-08-01Plan funding arrangement – InsuranceYes
2016-08-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

GHMSI (National Association of Insurance Commissioners NAIC id number: 53007 )
Policy contract number17KB
Policy instance 1
Insurance contract or identification number17KB
Number of Individuals Covered70
Insurance policy start date2019-03-01
Insurance policy end date2020-02-29
Total amount of commissions paid to insurance brokerUSD $2,669
Total amount of fees paid to insurance companyUSD $31,001
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $488,158
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,669
Amount paid for insurance broker fees27489
Additional information about fees paid to insurance brokerPERSISTENCY BONUS PRODUCER SERVICE FEE
Insurance broker organization code?3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number489598
Policy instance 2
Insurance contract or identification number489598
Number of Individuals Covered58
Insurance policy start date2019-03-01
Insurance policy end date2020-02-29
Total amount of commissions paid to insurance brokerUSD $31,455
Total amount of fees paid to insurance companyUSD $14,171
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT, ACCIDENT, CRITICAL ILLNESS, HOSPITAL, CANCER
Welfare Benefit Premiums Paid to CarrierUSD $278,747
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $31,455
Amount paid for insurance broker fees14171
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number10164401001
Policy instance 3
Insurance contract or identification number10164401001
Number of Individuals Covered79
Insurance policy start date2019-03-01
Insurance policy end date2020-02-29
Total amount of commissions paid to insurance brokerUSD $578
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $636
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $578
Amount paid for insurance broker fees0
Insurance broker organization code?3
GHMSI (National Association of Insurance Commissioners NAIC id number: 53007 )
Policy contract number17KB
Policy instance 1
Insurance contract or identification number17KB
Number of Individuals Covered113
Insurance policy start date2018-03-01
Insurance policy end date2019-02-28
Total amount of commissions paid to insurance brokerUSD $52,351
Total amount of fees paid to insurance companyUSD $29,533
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,047,012
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $52,351
Amount paid for insurance broker fees17269
Additional information about fees paid to insurance brokerMEDICAL CONTRACTS NON-MONETARY INCENTIVE
Insurance broker organization code?3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number489598
Policy instance 2
Insurance contract or identification number489598
Number of Individuals Covered104
Insurance policy start date2018-03-01
Insurance policy end date2019-02-28
Total amount of commissions paid to insurance brokerUSD $55,342
Total amount of fees paid to insurance companyUSD $1,198
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT, ACCIDENT, CRITICAL ILLNESS, HOSPITAL, CANCER
Welfare Benefit Premiums Paid to CarrierUSD $442,666
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $55,342
Amount paid for insurance broker fees1198
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number10164401001
Policy instance 3
Insurance contract or identification number10164401001
Number of Individuals Covered127
Insurance policy start date2018-03-01
Insurance policy end date2019-02-28
Total amount of commissions paid to insurance brokerUSD $1,115
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $11,146
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,115
Amount paid for insurance broker fees0
Insurance broker organization code?3
GHMSI (National Association of Insurance Commissioners NAIC id number: 53007 )
Policy contract number17KB
Policy instance 1
Insurance contract or identification number17KB
Number of Individuals Covered213
Insurance policy start date2017-03-01
Insurance policy end date2018-02-28
Total amount of commissions paid to insurance brokerUSD $89,354
Total amount of fees paid to insurance companyUSD $17,263
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,787,072
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $84,404
Amount paid for insurance broker fees58
Additional information about fees paid to insurance brokerNON-MONETARY INCENTIVE
Insurance broker organization code?3
Insurance broker nameEBCA
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number489598
Policy instance 2
Insurance contract or identification number489598
Number of Individuals Covered296
Insurance policy start date2017-08-01
Insurance policy end date2018-02-28
Total amount of commissions paid to insurance brokerUSD $35,075
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT, ACCIDENT, CRITICAL ILLNESS, CANCER
Welfare Benefit Premiums Paid to CarrierUSD $275,410
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $35,075
Amount paid for insurance broker fees0
Insurance broker organization code?3
Insurance broker nameEMPLOYEE BENEFITS GROUP, INC.

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