401k Plan data: APPLE HOMECARE MEDICAL SUPPLY plan

APPLE HOMECARE MEDICAL SUPPLY 401k Plan overview

Plan Name	APPLE HOMECARE MEDICAL SUPPLY
Plan identification number	501

APPLE HOMECARE MEDICAL SUPPLY 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 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

APPLE HOMECARE MEDICAL SUPPLY has sponsored the creation of one or more 401k plans.

Company Name: APPLE HOMECARE MEDICAL SUPPLY

Employer identification number (EIN): 752949402

NAIC Classification: 339110

Form 5500 Filing Information

Submission information for form 5500 for 401k plan APPLE HOMECARE MEDICAL SUPPLY

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2021-10-01 MEGAN CHENAULT 2023-05-02
501 2020-10-01 MEGAN CHENAULT 2022-04-21
501 2019-10-01 MEGAN CHENAULT 2021-07-18

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
501	2021-10-01	MEGAN CHENAULT	2023-05-02
501	2020-10-01	MEGAN CHENAULT	2022-04-21
501	2019-10-01	MEGAN CHENAULT	2021-07-18

Plan Statistics for APPLE HOMECARE MEDICAL SUPPLY

401k plan membership statisitcs for APPLE HOMECARE MEDICAL SUPPLY

Measure Date Value
2021: APPLE HOMECARE MEDICAL SUPPLY 2021 401k membership
Total participants, beginning-of-year 2021-10-01 167
Total number of active participants reported on line 7a of the Form 5500 2021-10-01 97
Total of all active and inactive participants 2021-10-01 97
2020: APPLE HOMECARE MEDICAL SUPPLY 2020 401k membership
Total participants, beginning-of-year 2020-10-01 147
Total number of active participants reported on line 7a of the Form 5500 2020-10-01 142
Total of all active and inactive participants 2020-10-01 142
2019: APPLE HOMECARE MEDICAL SUPPLY 2019 401k membership
Total participants, beginning-of-year 2019-10-01 114
Total number of active participants reported on line 7a of the Form 5500 2019-10-01 114
Total of all active and inactive participants 2019-10-01 114

Measure	Date	Value
2021: APPLE HOMECARE MEDICAL SUPPLY 2021 401k membership
Total participants, beginning-of-year	2021-10-01	167
Total number of active participants reported on line 7a of the Form 5500	2021-10-01	97
Total of all active and inactive participants	2021-10-01	97
2020: APPLE HOMECARE MEDICAL SUPPLY 2020 401k membership
Total participants, beginning-of-year	2020-10-01	147
Total number of active participants reported on line 7a of the Form 5500	2020-10-01	142
Total of all active and inactive participants	2020-10-01	142
2019: APPLE HOMECARE MEDICAL SUPPLY 2019 401k membership
Total participants, beginning-of-year	2019-10-01	114
Total number of active participants reported on line 7a of the Form 5500	2019-10-01	114
Total of all active and inactive participants	2019-10-01	114

Form 5500 Responses for APPLE HOMECARE MEDICAL SUPPLY

2021: APPLE HOMECARE MEDICAL SUPPLY 2021 form 5500 responses
2021-10-01	Type of plan entity	Single employer plan
2021-10-01	Submission has been amended	No
2021-10-01	This submission is the final filing	No
2021-10-01	This return/report is a short plan year return/report (less than 12 months)	No
2021-10-01	Plan is a collectively bargained plan	No
2021-10-01	Plan funding arrangement – Insurance	Yes
2021-10-01	Plan funding arrangement – General assets of the sponsor	Yes
2021-10-01	Plan benefit arrangement – Insurance	Yes
2021-10-01	Plan benefit arrangement – General assets of the sponsor	Yes
2020: APPLE HOMECARE MEDICAL SUPPLY 2020 form 5500 responses
2020-10-01	Type of plan entity	Single employer plan
2020-10-01	Submission has been amended	No
2020-10-01	This submission is the final filing	No
2020-10-01	This return/report is a short plan year return/report (less than 12 months)	No
2020-10-01	Plan is a collectively bargained plan	No
2020-10-01	Plan funding arrangement – Insurance	Yes
2020-10-01	Plan funding arrangement – General assets of the sponsor	Yes
2020-10-01	Plan benefit arrangement – Insurance	Yes
2020-10-01	Plan benefit arrangement – General assets of the sponsor	Yes
2019: APPLE HOMECARE MEDICAL SUPPLY 2019 form 5500 responses
2019-10-01	Type of plan entity	Single employer plan
2019-10-01	First time form 5500 has been submitted	Yes
2019-10-01	Submission has been amended	No
2019-10-01	This submission is the final filing	No
2019-10-01	This return/report is a short plan year return/report (less than 12 months)	No
2019-10-01	Plan is a collectively bargained plan	No
2019-10-01	Plan funding arrangement – Insurance	Yes
2019-10-01	Plan funding arrangement – General assets of the sponsor	Yes
2019-10-01	Plan benefit arrangement – Insurance	Yes
2019-10-01	Plan benefit arrangement – General assets of the sponsor	Yes

Insurance Providers Used on plan

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )

Policy contract number

00440857

Policy instance

Insurance contract or identification number	00440857
Number of Individuals Covered	107
Insurance policy start date	2021-10-01
Insurance policy end date	2022-09-30
Total amount of commissions paid to insurance broker	USD $10,798
Total amount of fees paid to insurance company	USD $1,034
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	Yes
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	AD&D
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 $82,675
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $10,798
Amount paid for insurance broker fees	1034
Additional information about fees paid to insurance broker	FEES PAID
Insurance broker organization code?	3

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )

Policy contract number

00440857

Policy instance

Insurance contract or identification number	00440857
Number of Individuals Covered	157
Insurance policy start date	2020-10-01
Insurance policy end date	2021-09-30
Total amount of commissions paid to insurance broker	USD $13,091
Total amount of fees paid to insurance company	USD $116
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	Yes
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	AD&D
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 $109,760
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $8,693
Amount paid for insurance broker fees	116
Additional information about fees paid to insurance broker	FEES PAID
Insurance broker organization code?	3

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )

Policy contract number

00440857

Policy instance

Insurance contract or identification number	00440857
Number of Individuals Covered	152
Insurance policy start date	2019-10-01
Insurance policy end date	2020-09-30
Total amount of commissions paid to insurance broker	USD $13,704
Total amount of fees paid to insurance company	USD $116
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	Yes
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	AD&D
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 $105,902
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $932
Insurance broker organization code?	3
Amount paid for insurance broker fees	116
Additional information about fees paid to insurance broker	FEES PAID

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Company Name:	APPLE HOMECARE MEDICAL SUPPLY
Employer identification number (EIN):	752949402
NAIC Classification:	339110