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MAYBROOK-C VALLEY VIEW 401k Plan overview

Plan NameMAYBROOK-C VALLEY VIEW
Plan identification number 501

MAYBROOK-C VALLEY VIEW Benefits

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

401k Sponsoring company profile

MAYBROOK-C VALLEY VIEW OPCO, LLC has sponsored the creation of one or more 401k plans.

Company Name:MAYBROOK-C VALLEY VIEW OPCO, LLC
Employer identification number (EIN):810808082
NAIC Classification:623000
NAIC Description: Nursing and Residential Care Facilities

Form 5500 Filing Information

Submission information for form 5500 for 401k plan MAYBROOK-C VALLEY VIEW

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012022-03-01DASA KRAUSS-ZOLDAN2023-06-13
5012021-03-01JONAH SVARC2022-08-18
5012020-03-01JONAH SVARC2021-12-09

Plan Statistics for MAYBROOK-C VALLEY VIEW

401k plan membership statisitcs for MAYBROOK-C VALLEY VIEW

Measure Date Value
2022: MAYBROOK-C VALLEY VIEW 2022 401k membership
Total participants, beginning-of-year2022-03-01138
Total number of active participants reported on line 7a of the Form 55002022-03-01137
Number of retired or separated participants receiving benefits2022-03-010
Number of other retired or separated participants entitled to future benefits2022-03-010
Total of all active and inactive participants2022-03-01137
Number of employers contributing to the scheme2022-03-010
2021: MAYBROOK-C VALLEY VIEW 2021 401k membership
Total participants, beginning-of-year2021-03-01132
Total number of active participants reported on line 7a of the Form 55002021-03-01127
Number of retired or separated participants receiving benefits2021-03-010
Number of other retired or separated participants entitled to future benefits2021-03-010
Total of all active and inactive participants2021-03-01127
Number of employers contributing to the scheme2021-03-010
2020: MAYBROOK-C VALLEY VIEW 2020 401k membership
Total participants, beginning-of-year2020-03-01154
Total number of active participants reported on line 7a of the Form 55002020-03-01148
Number of retired or separated participants receiving benefits2020-03-010
Number of other retired or separated participants entitled to future benefits2020-03-010
Total of all active and inactive participants2020-03-01148
Number of employers contributing to the scheme2020-03-010

Form 5500 Responses for MAYBROOK-C VALLEY VIEW

2022: MAYBROOK-C VALLEY VIEW 2022 form 5500 responses
2022-03-01Type of plan entitySingle employer plan
2022-03-01Plan funding arrangement – InsuranceYes
2022-03-01Plan benefit arrangement – InsuranceYes
2021: MAYBROOK-C VALLEY VIEW 2021 form 5500 responses
2021-03-01Type of plan entitySingle employer plan
2021-03-01Plan funding arrangement – InsuranceYes
2021-03-01Plan benefit arrangement – InsuranceYes
2020: MAYBROOK-C VALLEY VIEW 2020 form 5500 responses
2020-03-01Type of plan entitySingle employer plan
2020-03-01First time form 5500 has been submittedYes
2020-03-01Plan funding arrangement – InsuranceYes
2020-03-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number525160
Policy instance 1
Insurance contract or identification number525160
Number of Individuals Covered137
Insurance policy start date2022-03-01
Insurance policy end date2023-02-28
Total amount of commissions paid to insurance brokerUSD $8,563
Total amount of fees paid to insurance companyUSD $2,916
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $65,870
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,563
Amount paid for insurance broker fees2916
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number525160
Policy instance 1
Insurance contract or identification number525160
Number of Individuals Covered127
Insurance policy start date2021-03-01
Insurance policy end date2022-02-28
Total amount of commissions paid to insurance brokerUSD $8,303
Total amount of fees paid to insurance companyUSD $3,612
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $63,871
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,303
Amount paid for insurance broker fees3612
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number525160
Policy instance 1
Insurance contract or identification number525160
Number of Individuals Covered148
Insurance policy start date2020-03-01
Insurance policy end date2021-02-28
Total amount of commissions paid to insurance brokerUSD $9,914
Total amount of fees paid to insurance companyUSD $2,596
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $76,263
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9,914
Amount paid for insurance broker fees2596
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3

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