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BROOKDALE DRUG & ALCOHOL REHABILITATION CENTER LLC GROUP MEDICAL PLAN 401k Plan overview

Plan NameBROOKDALE DRUG & ALCOHOL REHABILITATION CENTER LLC GROUP MEDICAL PLAN
Plan identification number 501

BROOKDALE DRUG & ALCOHOL REHABILITATION CENTER LLC GROUP MEDICAL PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)

401k Sponsoring company profile

BROOKDALE DRUG & ALCOHOL REHABILITATION CENTER, LLC has sponsored the creation of one or more 401k plans.

Company Name:BROOKDALE DRUG & ALCOHOL REHABILITATION CENTER, LLC
Employer identification number (EIN):830517812
NAIC Classification:621498
NAIC Description:All Other Outpatient Care Centers

Form 5500 Filing Information

Submission information for form 5500 for 401k plan BROOKDALE DRUG & ALCOHOL REHABILITATION CENTER LLC GROUP MEDICAL PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012021-07-01
5012020-08-01

Plan Statistics for BROOKDALE DRUG & ALCOHOL REHABILITATION CENTER LLC GROUP MEDICAL PLAN

401k plan membership statisitcs for BROOKDALE DRUG & ALCOHOL REHABILITATION CENTER LLC GROUP MEDICAL PLAN

Measure Date Value
2021: BROOKDALE DRUG & ALCOHOL REHABILITATION CENTER LLC GROUP MEDICAL PLAN 2021 401k membership
Total participants, beginning-of-year2021-07-01120
Total number of active participants reported on line 7a of the Form 55002021-07-01121
Number of retired or separated participants receiving benefits2021-07-011
Number of other retired or separated participants entitled to future benefits2021-07-010
Total of all active and inactive participants2021-07-01122
2020: BROOKDALE DRUG & ALCOHOL REHABILITATION CENTER LLC GROUP MEDICAL PLAN 2020 401k membership
Total participants, beginning-of-year2020-08-01122
Total number of active participants reported on line 7a of the Form 55002020-08-01119
Number of retired or separated participants receiving benefits2020-08-011
Number of other retired or separated participants entitled to future benefits2020-08-010
Total of all active and inactive participants2020-08-01120

Financial Data on BROOKDALE DRUG & ALCOHOL REHABILITATION CENTER LLC GROUP MEDICAL PLAN

Measure Date Value
2022 : BROOKDALE DRUG & ALCOHOL REHABILITATION CENTER LLC GROUP MEDICAL PLAN 2022 401k financial data
Total unrealized appreciation/depreciation of assets2022-06-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-06-30$347,418
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-06-30$180,227
Total income from all sources (including contributions)2022-06-30$1,501,817
Total loss/gain on sale of assets2022-06-30$0
Total of all expenses incurred2022-06-30$1,423,315
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-06-30$956,217
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-06-30$1,501,685
Value of total assets at end of year2022-06-30$257,128
Value of total assets at beginning of year2022-06-30$11,435
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-06-30$467,098
Total interest from all sources2022-06-30$132
Total dividends received (eg from common stock, registered investment company shares)2022-06-30$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2022-06-30No
Was this plan covered by a fidelity bond2022-06-30Yes
Value of fidelity bond cover2022-06-30$500,000
If this is an individual account plan, was there a blackout period2022-06-30No
Were there any nonexempt tranactions with any party-in-interest2022-06-30No
Contributions received from participants2022-06-30$159,353
Value of other receiveables (less allowance for doubtful accounts) at end of year2022-06-30$121,660
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2022-06-30$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2022-06-30$195,038
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2022-06-30$180,227
Administrative expenses (other) incurred2022-06-30$379,751
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-06-30No
Value of net income/loss2022-06-30$78,502
Value of net assets at end of year (total assets less liabilities)2022-06-30$-90,290
Value of net assets at beginning of year (total assets less liabilities)2022-06-30$-168,792
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2022-06-30No
Were any loans by the plan or fixed income obligations due to the plan in default2022-06-30No
Were any leases to which the plan was party in default or uncollectible2022-06-30No
Investment advisory and management fees2022-06-30$29,464
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2022-06-30$135,468
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2022-06-30$11,435
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2022-06-30$11,435
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2022-06-30$132
Expenses. Payments to insurance carriers foe the provision of benefits2022-06-30$956,217
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2022-06-30No
Was there a failure to transmit to the plan any participant contributions2022-06-30No
Has the plan failed to provide any benefit when due under the plan2022-06-30No
Contributions received in cash from employer2022-06-30$1,342,332
Contract administrator fees2022-06-30$57,883
Liabilities. Value of benefit claims payable at end of year2022-06-30$152,380
Liabilities. Value of benefit claims payable at beginning of year2022-06-30$0
Did the plan have assets held for investment2022-06-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2022-06-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2022-06-30No
Opinion of an independent qualified public accountant for this plan2022-06-30Unqualified
Accountancy firm name2022-06-30YOUNG, OAKES, BROWN & COMPANY PC
Accountancy firm EIN2022-06-30251589048
2021 : BROOKDALE DRUG & ALCOHOL REHABILITATION CENTER LLC GROUP MEDICAL PLAN 2021 401k financial data
Total unrealized appreciation/depreciation of assets2021-06-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-06-30$180,227
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-06-30$0
Total income from all sources (including contributions)2021-06-30$1,208,736
Total loss/gain on sale of assets2021-06-30$0
Total of all expenses incurred2021-06-30$1,377,528
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-06-30$989,201
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-06-30$1,208,637
Value of total assets at end of year2021-06-30$11,435
Value of total assets at beginning of year2021-06-30$0
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-06-30$388,327
Total interest from all sources2021-06-30$99
Total dividends received (eg from common stock, registered investment company shares)2021-06-30$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2021-06-30No
Was this plan covered by a fidelity bond2021-06-30Yes
Value of fidelity bond cover2021-06-30$500,000
If this is an individual account plan, was there a blackout period2021-06-30No
Were there any nonexempt tranactions with any party-in-interest2021-06-30No
Contributions received from participants2021-06-30$137,434
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2021-06-30$180,227
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2021-06-30$0
Administrative expenses (other) incurred2021-06-30$304,725
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2021-06-30No
Value of net income/loss2021-06-30$-168,792
Value of net assets at end of year (total assets less liabilities)2021-06-30$-168,792
Value of net assets at beginning of year (total assets less liabilities)2021-06-30$0
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2021-06-30No
Were any loans by the plan or fixed income obligations due to the plan in default2021-06-30No
Were any leases to which the plan was party in default or uncollectible2021-06-30No
Investment advisory and management fees2021-06-30$29,052
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2021-06-30$11,435
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2021-06-30$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2021-06-30$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2021-06-30$99
Expenses. Payments to insurance carriers foe the provision of benefits2021-06-30$989,201
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2021-06-30No
Was there a failure to transmit to the plan any participant contributions2021-06-30No
Has the plan failed to provide any benefit when due under the plan2021-06-30No
Contributions received in cash from employer2021-06-30$1,071,203
Contract administrator fees2021-06-30$54,550
Did the plan have assets held for investment2021-06-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2021-06-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2021-06-30No
Opinion of an independent qualified public accountant for this plan2021-06-30Unqualified
Accountancy firm name2021-06-30YOUNG, OAKES, BROWN & COMPANY PC
Accountancy firm EIN2021-06-30251589048

Form 5500 Responses for BROOKDALE DRUG & ALCOHOL REHABILITATION CENTER LLC GROUP MEDICAL PLAN

2021: BROOKDALE DRUG & ALCOHOL REHABILITATION CENTER LLC GROUP MEDICAL PLAN 2021 form 5500 responses
2021-07-01Type of plan entitySingle employer plan
2021-07-01Submission has been amendedNo
2021-07-01This submission is the final filingNo
2021-07-01This return/report is a short plan year return/report (less than 12 months)No
2021-07-01Plan is a collectively bargained planNo
2021-07-01Plan funding arrangement – InsuranceYes
2021-07-01Plan funding arrangement – TrustYes
2021-07-01Plan benefit arrangement – InsuranceYes
2021-07-01Plan benefit arrangement - TrustYes
2020: BROOKDALE DRUG & ALCOHOL REHABILITATION CENTER LLC GROUP MEDICAL PLAN 2020 form 5500 responses
2020-08-01Type of plan entitySingle employer plan
2020-08-01First time form 5500 has been submittedYes
2020-08-01Submission has been amendedNo
2020-08-01This submission is the final filingNo
2020-08-01This return/report is a short plan year return/report (less than 12 months)Yes
2020-08-01Plan is a collectively bargained planNo
2020-08-01Plan funding arrangement – InsuranceYes
2020-08-01Plan funding arrangement – TrustYes
2020-08-01Plan benefit arrangement – InsuranceYes
2020-08-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

EVEREST REINSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number31000158
Policy instance 1
Insurance contract or identification number31000158
Number of Individuals Covered121
Insurance policy start date2021-07-01
Insurance policy end date2022-06-30
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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 CarrierUSD $379,751
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EVEREST REINSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number31000158
Policy instance 1
Insurance contract or identification number31000158
Number of Individuals Covered120
Insurance policy start date2020-08-01
Insurance policy end date2021-06-30
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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 CarrierUSD $304,725
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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