401k Plan data: HEALTHACTIONS EMPLOYEE BENEFITS WELFARE PLAN plan

HEALTHACTIONS EMPLOYEE BENEFITS WELFARE PLAN 401k Plan overview

Plan Name	HEALTHACTIONS EMPLOYEE BENEFITS WELFARE PLAN
Plan identification number	501

HEALTHACTIONS EMPLOYEE BENEFITS WELFARE PLAN Benefits

401k Plan Type	Welfare 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) Other welfare benefit 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.

401k Sponsoring company profile

HEALTHACTIONS PHYSICAL THERAPY AND WELLNESS has sponsored the creation of one or more 401k plans.

Company Name: HEALTHACTIONS PHYSICAL THERAPY AND WELLNESS

Employer identification number (EIN): 630815380

NAIC Classification: 621340
NAIC Description: Offices of Physical, Occupational and Speech Therapists, and Audiologists

Form 5500 Filing Information

Submission information for form 5500 for 401k plan HEALTHACTIONS EMPLOYEE BENEFITS WELFARE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2022-08-01 JEAN WEATHERLY 2023-10-16
501 2021-08-01 JEAN WEATHERLY 2023-03-23

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
501	2022-08-01	JEAN WEATHERLY	2023-10-16
501	2021-08-01	JEAN WEATHERLY	2023-03-23

Plan Statistics for HEALTHACTIONS EMPLOYEE BENEFITS WELFARE PLAN

401k plan membership statisitcs for HEALTHACTIONS EMPLOYEE BENEFITS WELFARE PLAN

Measure Date Value
2022: HEALTHACTIONS EMPLOYEE BENEFITS WELFARE PLAN 2022 401k membership
Total participants, beginning-of-year 2022-08-01 104
Total number of active participants reported on line 7a of the Form 5500 2022-08-01 104
Number of retired or separated participants receiving benefits 2022-08-01 0
Number of other retired or separated participants entitled to future benefits 2022-08-01 0
Total of all active and inactive participants 2022-08-01 104
Number of employers contributing to the scheme 2022-08-01 0
2021: HEALTHACTIONS EMPLOYEE BENEFITS WELFARE PLAN 2021 401k membership
Total participants, beginning-of-year 2021-08-01 100
Total number of active participants reported on line 7a of the Form 5500 2021-08-01 78
Number of retired or separated participants receiving benefits 2021-08-01 0
Number of other retired or separated participants entitled to future benefits 2021-08-01 0
Total of all active and inactive participants 2021-08-01 78
Number of employers contributing to the scheme 2021-08-01 0

Measure	Date	Value
2022: HEALTHACTIONS EMPLOYEE BENEFITS WELFARE PLAN 2022 401k membership
Total participants, beginning-of-year	2022-08-01	104
Total number of active participants reported on line 7a of the Form 5500	2022-08-01	104
Number of retired or separated participants receiving benefits	2022-08-01	0
Number of other retired or separated participants entitled to future benefits	2022-08-01	0
Total of all active and inactive participants	2022-08-01	104
Number of employers contributing to the scheme	2022-08-01	0
2021: HEALTHACTIONS EMPLOYEE BENEFITS WELFARE PLAN 2021 401k membership
Total participants, beginning-of-year	2021-08-01	100
Total number of active participants reported on line 7a of the Form 5500	2021-08-01	78
Number of retired or separated participants receiving benefits	2021-08-01	0
Number of other retired or separated participants entitled to future benefits	2021-08-01	0
Total of all active and inactive participants	2021-08-01	78
Number of employers contributing to the scheme	2021-08-01	0

Form 5500 Responses for HEALTHACTIONS EMPLOYEE BENEFITS WELFARE PLAN

2022: HEALTHACTIONS EMPLOYEE BENEFITS WELFARE PLAN 2022 form 5500 responses
2022-08-01	Type of plan entity	Single employer plan
2022-08-01	Plan funding arrangement – Insurance	Yes
2022-08-01	Plan benefit arrangement – Insurance	Yes
2021: HEALTHACTIONS EMPLOYEE BENEFITS WELFARE PLAN 2021 form 5500 responses
2021-08-01	Type of plan entity	Single employer plan
2021-08-01	First time form 5500 has been submitted	Yes
2021-08-01	Plan funding arrangement – Insurance	Yes
2021-08-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

BLUE CROSS BLUE SHIELD OF ALABAMA (National Association of Insurance Commissioners NAIC id number: 55433 )

Policy contract number

42397

Policy instance

Insurance contract or identification number	42397
Number of Individuals Covered	108
Insurance policy start date	2022-08-01
Insurance policy end date	2023-07-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Health Insurance Welfare Benefit	Yes
Dental Insurance Welfare Benefit	Yes
Other welfare benefits provided	WELLNESS PROGRAM
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )

Policy contract number

169278

Policy instance

Insurance contract or identification number	169278
Number of Individuals Covered	104
Insurance policy start date	2022-08-01
Insurance policy end date	2023-07-31
Total amount of commissions paid to insurance broker	USD $9,032
Total amount of fees paid to insurance company	USD $3,184
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	Yes
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	ACCIDENTAL DEATH AND DISMEMBERMENT,EMPLOYEE ASSISTANCE PROGRAM,ACCIDENT, CRITICAL ILLNESS
Welfare Benefit Premiums Paid to Carrier	USD $11,939
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $8,657
Amount paid for insurance broker fees	0
Insurance broker organization code?	3
Additional information about fees paid to insurance broker	ADMINISTRATIVE

BLUE CROSS BLUE SHIELD OF ALABAMA (National Association of Insurance Commissioners NAIC id number: 55433 )

Policy contract number

42397

Policy instance

Insurance contract or identification number	42397
Number of Individuals Covered	89
Insurance policy start date	2021-08-01
Insurance policy end date	2022-07-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Health Insurance Welfare Benefit	Yes
Dental Insurance Welfare Benefit	Yes
Other welfare benefits provided	WELLNESS PROGRAM
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )

Policy contract number

169278

Policy instance

Insurance contract or identification number	169278
Number of Individuals Covered	78
Insurance policy start date	2021-08-01
Insurance policy end date	2022-07-31
Total amount of commissions paid to insurance broker	USD $7,287
Total amount of fees paid to insurance company	USD $2,648
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	Yes
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	ACCIDENTAL DEATH AND DISMEMBERMENT,EMPLOYEE ASSISTANCE PROGRAM,ACCIDENT, CRITICAL ILLNESS
Welfare Benefit Premiums Paid to Carrier	USD $65,264
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $7,287
Amount paid for insurance broker fees	1892
Additional information about fees paid to insurance broker	CONTINGENT COMPENSATION
Insurance broker organization code?	3

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Company Name:	HEALTHACTIONS PHYSICAL THERAPY AND WELLNESS
Employer identification number (EIN):	630815380
NAIC Classification:	621340
NAIC Description:	Offices of Physical, Occupational and Speech Therapists, and Audiologists