401k Plan data: WASHINGTON PRIME GROUP EMPLOYEE WELFARE BENEFIT PLAN plan

WASHINGTON PRIME GROUP EMPLOYEE WELFARE BENEFIT PLAN 401k Plan overview

Plan Name	WASHINGTON PRIME GROUP EMPLOYEE WELFARE BENEFIT PLAN
Plan identification number	513

WASHINGTON PRIME GROUP EMPLOYEE WELFARE BENEFIT 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 Other welfare benefit cover

401k Sponsoring company profile

WPG REAL ESTATE ASSOCIATES LLC has sponsored the creation of one or more 401k plans.

Company Name: WPG REAL ESTATE ASSOCIATES LLC

Employer identification number (EIN): 872963007

NAIC Classification: 531390
NAIC Description: Other Activities Related to Real Estate

Form 5500 Filing Information

Submission information for form 5500 for 401k plan WASHINGTON PRIME GROUP EMPLOYEE WELFARE BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
513 2022-01-01 HOPE DAVIES 2023-06-20

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
513	2022-01-01	HOPE DAVIES	2023-06-20

Plan Statistics for WASHINGTON PRIME GROUP EMPLOYEE WELFARE BENEFIT PLAN

401k plan membership statisitcs for WASHINGTON PRIME GROUP EMPLOYEE WELFARE BENEFIT PLAN

Measure Date Value
2022: WASHINGTON PRIME GROUP EMPLOYEE WELFARE BENEFIT PLAN 2022 401k membership
Total participants, beginning-of-year 2022-01-01 678
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 476
Number of retired or separated participants receiving benefits 2022-01-01 10
Total of all active and inactive participants 2022-01-01 486

Measure	Date	Value
2022: WASHINGTON PRIME GROUP EMPLOYEE WELFARE BENEFIT PLAN 2022 401k membership
Total participants, beginning-of-year	2022-01-01	678
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	476
Number of retired or separated participants receiving benefits	2022-01-01	10
Total of all active and inactive participants	2022-01-01	486

Form 5500 Responses for WASHINGTON PRIME GROUP EMPLOYEE WELFARE BENEFIT PLAN

2022: WASHINGTON PRIME GROUP EMPLOYEE WELFARE BENEFIT PLAN 2022 form 5500 responses
2022-01-01	Type of plan entity	Single employer plan
2022-01-01	Plan funding arrangement – Insurance	Yes
2022-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2022-01-01	Plan benefit arrangement – Insurance	Yes
2022-01-01	Plan benefit arrangement – General assets of the sponsor	Yes

Insurance Providers Used on plan

DELTA DENTAL OF OHIO (National Association of Insurance Commissioners NAIC id number: 54402 )

Policy contract number

10017

Policy instance

Insurance contract or identification number	10017
Number of Individuals Covered	894
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of fees paid to insurance company	USD $556
Dental Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Amount paid for insurance broker fees	556
Additional information about fees paid to insurance broker	BONUS
Insurance broker organization code?	3

EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )

Policy contract number

98578301001

Policy instance

Insurance contract or identification number	98578301001
Number of Individuals Covered	852
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $2,364
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $50,239
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,364
Insurance broker organization code?	3

UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )

Policy contract number

307011

Policy instance

Insurance contract or identification number	307011
Number of Individuals Covered	476
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Other welfare benefits provided	AD&D, VOLUNTARY LIFE
Welfare Benefit Premiums Paid to Carrier	USD $652,635
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

HAWAII MEDICAL SERVICE ASSOCIATION (National Association of Insurance Commissioners NAIC id number: 95804 )

Policy contract number

21480 1

Policy instance

Insurance contract or identification number	21480 1
Number of Individuals Covered	21
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $163,943
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

UNITED BEHAVIORAL HEALTH DBA OPTUM (National Association of Insurance Commissioners NAIC id number: 79413 )

Policy contract number

000000002288

Policy instance

Insurance contract or identification number	000000002288
Number of Individuals Covered	463
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Other welfare benefits provided	EMPLOYEE ASSISTANCE PROGRAM
Welfare Benefit Premiums Paid to Carrier	USD $12,309
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

Potentially related plans

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Company Name:	WPG REAL ESTATE ASSOCIATES LLC
Employer identification number (EIN):	872963007
NAIC Classification:	531390
NAIC Description:	Other Activities Related to Real Estate