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| Plan Name | NEW LIFE HOME HEALTH CARE AGENCY EMPLOYEE BENEFITS PLAN |
| Plan identification number | 501 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | NEW LIFE HOME HEALTH CARE AGENCY |
| Employer identification number (EIN): | 810600546 |
| NAIC Classification: | 621610 |
| NAIC Description: | Home Health Care Services |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 501 | 2020-08-01 | BORIS APEL | 2022-04-19 |
| 2020: NEW LIFE HOME HEALTH CARE AGENCY EMPLOYEE BENEFITS PLAN 2020 form 5500 responses | ||
|---|---|---|
| 2020-08-01 | Type of plan entity | Single employer plan |
| 2020-08-01 | First time form 5500 has been submitted | Yes |
| 2020-08-01 | Plan funding arrangement – Insurance | Yes |
| 2020-08-01 | Plan benefit arrangement – Insurance | Yes |
| KEYSTONE HEALTH PLAN EAST (National Association of Insurance Commissioners NAIC id number: 95056 ) | |
| Policy contract number | 1041154 |
| Policy instance | 1 |
| INDEPENDENCE BLUE CROSS (National Association of Insurance Commissioners NAIC id number: 93688 ) | |
| Policy contract number | 1041154 |
| Policy instance | 2 |
| UNITED CONCORDIA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 85766 ) | |
| Policy contract number | 922589-099 |
| Policy instance | 3 |
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