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| Plan Name | ROZE ROOM HOSPICE WELFARE BENEFITS PLAN |
| Plan identification number | 501 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
|
| Company Name: | L & A CARE CORPORATION DBA ROZE ROOM HOSPICE |
| Employer identification number (EIN): | 954643592 |
| NAIC Classification: | 623000 |
| NAIC Description: | Nursing and Residential Care Facilities |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 501 | 2023-12-01 | LENA BEKER | |||
| 501 | 2022-12-01 | ||||
| 501 | 2022-12-01 | LENA BEKER | |||
| 501 | 2021-12-01 | ||||
| 501 | 2021-12-01 | LENA BEKER | |||
| 501 | 2020-12-01 | ||||
| 501 | 2019-12-01 | ||||
| 501 | 2018-12-01 | ||||
| 501 | 2018-06-01 | LENA BEKER | |||
| 501 | 2017-06-01 | LENA BEKER | |||
| 501 | 2016-06-01 | LENA BEKER | |||
| 501 | 2015-06-01 | LENA BEKER | |||
| 501 | 2014-06-01 | LENA BEKER | |||
| 501 | 2013-06-01 | LENA BEKER | |||
| 501 | 2012-06-01 | LENA BEKER | |||
| 501 | 2011-06-01 | LENA BEKER | |||
| 501 | 2010-06-01 | LENA BEKER |
| 2022: ROZE ROOM HOSPICE WELFARE BENEFITS PLAN 2022 form 5500 responses | ||
|---|---|---|
| 2022-12-01 | Type of plan entity | Single employer plan |
| 2022-12-01 | Submission has been amended | No |
| 2022-12-01 | This submission is the final filing | No |
| 2022-12-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2022-12-01 | Plan is a collectively bargained plan | No |
| 2022-12-01 | Plan funding arrangement – Insurance | Yes |
| 2022-12-01 | Plan benefit arrangement – Insurance | Yes |
| 2021: ROZE ROOM HOSPICE WELFARE BENEFITS PLAN 2021 form 5500 responses | ||
| 2021-12-01 | Type of plan entity | Single employer plan |
| 2021-12-01 | Submission has been amended | No |
| 2021-12-01 | This submission is the final filing | No |
| 2021-12-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2021-12-01 | Plan is a collectively bargained plan | No |
| 2021-12-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2021-12-01 | Plan benefit arrangement – Insurance | Yes |
| 2020: ROZE ROOM HOSPICE WELFARE BENEFITS PLAN 2020 form 5500 responses | ||
| 2020-12-01 | Type of plan entity | Single employer plan |
| 2020-12-01 | Submission has been amended | No |
| 2020-12-01 | This submission is the final filing | No |
| 2020-12-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2020-12-01 | Plan is a collectively bargained plan | No |
| 2020-12-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2020-12-01 | Plan benefit arrangement – Insurance | Yes |
| 2019: ROZE ROOM HOSPICE WELFARE BENEFITS PLAN 2019 form 5500 responses | ||
| 2019-12-01 | Type of plan entity | Single employer plan |
| 2019-12-01 | Submission has been amended | No |
| 2019-12-01 | This submission is the final filing | No |
| 2019-12-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2019-12-01 | Plan is a collectively bargained plan | No |
| 2019-12-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2019-12-01 | Plan benefit arrangement – Insurance | Yes |
| 2018: ROZE ROOM HOSPICE WELFARE BENEFITS PLAN 2018 form 5500 responses | ||
| 2018-12-01 | Type of plan entity | Single employer plan |
| 2018-12-01 | Submission has been amended | No |
| 2018-12-01 | This submission is the final filing | No |
| 2018-12-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2018-12-01 | Plan is a collectively bargained plan | No |
| 2018-12-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2018-12-01 | Plan benefit arrangement – Insurance | Yes |
| 2018-06-01 | Type of plan entity | Single employer plan |
| 2018-06-01 | Submission has been amended | No |
| 2018-06-01 | This submission is the final filing | No |
| 2018-06-01 | This return/report is a short plan year return/report (less than 12 months) | Yes |
| 2018-06-01 | Plan is a collectively bargained plan | No |
| 2018-06-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2018-06-01 | Plan benefit arrangement – Insurance | Yes |
| 2017: ROZE ROOM HOSPICE WELFARE BENEFITS PLAN 2017 form 5500 responses | ||
| 2017-06-01 | Type of plan entity | Single employer plan |
| 2017-06-01 | Submission has been amended | No |
| 2017-06-01 | This submission is the final filing | No |
| 2017-06-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2017-06-01 | Plan is a collectively bargained plan | No |
| 2017-06-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2017-06-01 | Plan benefit arrangement – Insurance | Yes |
| 2016: ROZE ROOM HOSPICE WELFARE BENEFITS PLAN 2016 form 5500 responses | ||
| 2016-06-01 | Type of plan entity | Single employer plan |
| 2016-06-01 | Submission has been amended | No |
| 2016-06-01 | This submission is the final filing | No |
| 2016-06-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2016-06-01 | Plan is a collectively bargained plan | No |
| 2016-06-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2016-06-01 | Plan benefit arrangement – Insurance | Yes |
| 2015: ROZE ROOM HOSPICE WELFARE BENEFITS PLAN 2015 form 5500 responses | ||
| 2015-06-01 | Type of plan entity | Single employer plan |
| 2015-06-01 | Submission has been amended | No |
| 2015-06-01 | This submission is the final filing | No |
| 2015-06-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2015-06-01 | Plan is a collectively bargained plan | No |
| 2015-06-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2015-06-01 | Plan benefit arrangement – Insurance | Yes |
| 2014: ROZE ROOM HOSPICE WELFARE BENEFITS PLAN 2014 form 5500 responses | ||
| 2014-06-01 | Type of plan entity | Single employer plan |
| 2014-06-01 | Submission has been amended | No |
| 2014-06-01 | This submission is the final filing | No |
| 2014-06-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2014-06-01 | Plan is a collectively bargained plan | No |
| 2014-06-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2014-06-01 | Plan benefit arrangement – Insurance | Yes |
| 2013: ROZE ROOM HOSPICE WELFARE BENEFITS PLAN 2013 form 5500 responses | ||
| 2013-06-01 | Type of plan entity | Single employer plan |
| 2013-06-01 | Submission has been amended | No |
| 2013-06-01 | This submission is the final filing | No |
| 2013-06-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2013-06-01 | Plan is a collectively bargained plan | No |
| 2013-06-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2013-06-01 | Plan benefit arrangement – Insurance | Yes |
| 2012: ROZE ROOM HOSPICE WELFARE BENEFITS PLAN 2012 form 5500 responses | ||
| 2012-06-01 | Type of plan entity | Single employer plan |
| 2012-06-01 | Submission has been amended | No |
| 2012-06-01 | This submission is the final filing | No |
| 2012-06-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2012-06-01 | Plan is a collectively bargained plan | No |
| 2012-06-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2012-06-01 | Plan benefit arrangement – Insurance | Yes |
| 2011: ROZE ROOM HOSPICE WELFARE BENEFITS PLAN 2011 form 5500 responses | ||
| 2011-06-01 | Type of plan entity | Single employer plan |
| 2011-06-01 | Submission has been amended | No |
| 2011-06-01 | This submission is the final filing | No |
| 2011-06-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2011-06-01 | Plan is a collectively bargained plan | No |
| 2011-06-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2011-06-01 | Plan benefit arrangement – Insurance | Yes |
| 2010: ROZE ROOM HOSPICE WELFARE BENEFITS PLAN 2010 form 5500 responses | ||
| 2010-06-01 | Type of plan entity | Single employer plan |
| 2010-06-01 | First time form 5500 has been submitted | Yes |
| 2010-06-01 | Submission has been amended | No |
| 2010-06-01 | This submission is the final filing | No |
| 2010-06-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2010-06-01 | Plan is a collectively bargained plan | No |
| 2010-06-01 | Plan funding arrangement – Insurance | Yes |
| 2010-06-01 | Plan benefit arrangement – Insurance | Yes |
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) | |
| Policy contract number | 00426728 |
| Policy instance | 1 |
| CALIFORNIACHOICE (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | VARIOUS |
| Policy instance | 2 |
| CALIFORNIACHOICE (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | VARIOUS |
| Policy instance | 3 |
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) | |
| Policy contract number | 00426728 |
| Policy instance | 2 |
| CALIFORNIACHOICE (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | 74130 |
| Policy instance | 1 |
| CALIFORNIACHOICE (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | VARIOUS |
| Policy instance | 1 |
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) | |
| Policy contract number | 00426728 |
| Policy instance | 2 |
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) | |
| Policy contract number | 00426728 |
| Policy instance | 2 |
| CALIFORNIACHOICE (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | VARIOUS |
| Policy instance | 1 |
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) | |
| Policy contract number | 00426728 |
| Policy instance | 2 |
| CALIFORNIACHOICE (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | VARIOUS |
| Policy instance | 1 |
| CALIFORNIACHOICE (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | VARIOUS |
| Policy instance | 2 |
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) | |
| Policy contract number | 00426728 |
| Policy instance | 1 |
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | 292978 |
| Policy instance | 1 |
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | 292975 |
| Policy instance | 2 |
| UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 ) | |
| Policy contract number | 5437064 |
| Policy instance | 3 |
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | 292976 |
| Policy instance | 4 |
| UDC DENTAL OF CALIFORNIA, INC. (National Association of Insurance Commissioners NAIC id number: 52031 ) | |
| Policy contract number | 5437064 |
| Policy instance | 5 |
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) | |
| Policy contract number | 00426728 |
| Policy instance | 6 |
| AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) | |
| Policy contract number | 89271357 |
| Policy instance | 7 |
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) | |
| Policy contract number | 00426728 |
| Policy instance | 5 |
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | 292978 |
| Policy instance | 4 |
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | 292975 |
| Policy instance | 3 |
| UDC DENTAL OF CALIFORNIA, INC. (National Association of Insurance Commissioners NAIC id number: 52031 ) | |
| Policy contract number | 5437064 |
| Policy instance | 2 |
| UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 ) | |
| Policy contract number | 5437064 |
| Policy instance | 1 |
| AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) | |
| Policy contract number | 89271357 |
| Policy instance | 6 |
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | 292976 |
| Policy instance | 7 |
| AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) | |
| Policy contract number | 89271357 |
| Policy instance | 4 |
| UDC DENTAL OF CALIFORNIA, INC. (National Association of Insurance Commissioners NAIC id number: 52031 ) | |
| Policy contract number | 5437064 |
| Policy instance | 6 |
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | 292975 |
| Policy instance | 7 |
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | 292976 |
| Policy instance | 3 |
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) | |
| Policy contract number | 00426728 |
| Policy instance | 2 |
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | 292978 |
| Policy instance | 1 |
| UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 ) | |
| Policy contract number | 5437064 |
| Policy instance | 5 |
| AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) | |
| Policy contract number | 89282044 |
| Policy instance | 10 |
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | 292975 |
| Policy instance | 7 |
| UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 ) | |
| Policy contract number | 5437064 |
| Policy instance | 9 |
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | 292976 |
| Policy instance | 8 |
| AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) | |
| Policy contract number | 89269906 |
| Policy instance | 12 |
| AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) | |
| Policy contract number | 89285877 |
| Policy instance | 5 |
| UDC DENTAL OF CALIFORNIA, INC. (National Association of Insurance Commissioners NAIC id number: 52031 ) | |
| Policy contract number | 5437064 |
| Policy instance | 4 |
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | 292978 |
| Policy instance | 6 |
| AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) | |
| Policy contract number | 89266058 |
| Policy instance | 3 |
| AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) | |
| Policy contract number | 89271357 |
| Policy instance | 2 |
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) | |
| Policy contract number | 00426728 |
| Policy instance | 1 |
| AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) | |
| Policy contract number | 89273061 |
| Policy instance | 11 |
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | 292976 |
| Policy instance | 5 |
| HEALTH NET (National Association of Insurance Commissioners NAIC id number: 95567 ) | |
| Policy contract number | DC789 |
| Policy instance | 6 |
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | 292975 |
| Policy instance | 10 |
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) | |
| Policy contract number | 00426728 |
| Policy instance | 8 |
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | 292978 |
| Policy instance | 2 |
| HEALTH NET (National Association of Insurance Commissioners NAIC id number: 95567 ) | |
| Policy contract number | RH529 |
| Policy instance | 3 |
| HEALTH NET (National Association of Insurance Commissioners NAIC id number: 95567 ) | |
| Policy contract number | RH454 |
| Policy instance | 4 |
| HEALTH NET (National Association of Insurance Commissioners NAIC id number: 95567 ) | |
| Policy contract number | RH383 |
| Policy instance | 1 |
| UDC DENTAL OF CALIFORNIA, INC. (National Association of Insurance Commissioners NAIC id number: 52031 ) | |
| Policy contract number | 5437064 |
| Policy instance | 7 |
| UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 ) | |
| Policy contract number | 5437064 |
| Policy instance | 9 |
| UDC DENTAL OF CALIFORNIA, INC. (National Association of Insurance Commissioners NAIC id number: 52031 ) | |
| Policy contract number | 5437064 |
| Policy instance | 5 |
| UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 ) | |
| Policy contract number | 5437064 |
| Policy instance | 2 |
| HEALTH NET (National Association of Insurance Commissioners NAIC id number: 95567 ) | |
| Policy contract number | RH529 |
| Policy instance | 10 |
| HEALTH NET (National Association of Insurance Commissioners NAIC id number: 95567 ) | |
| Policy contract number | RH454 |
| Policy instance | 1 |
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | 292975 |
| Policy instance | 3 |
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | 292976 |
| Policy instance | 4 |
| HEALTH NET (National Association of Insurance Commissioners NAIC id number: 95567 ) | |
| Policy contract number | RH385 |
| Policy instance | 6 |
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | 292978 |
| Policy instance | 7 |
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) | |
| Policy contract number | 00426728 |
| Policy instance | 8 |
| HEALTH NET (National Association of Insurance Commissioners NAIC id number: 95567 ) | |
| Policy contract number | DC789 |
| Policy instance | 9 |
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) | |
| Policy contract number | 00426728 |
| Policy instance | 2 |
| HEALTH NET (National Association of Insurance Commissioners NAIC id number: 95567 ) | |
| Policy contract number | BC956 |
| Policy instance | 4 |
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | 292976 |
| Policy instance | 6 |
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | 292978 |
| Policy instance | 7 |
| HEALTH NET (National Association of Insurance Commissioners NAIC id number: 95567 ) | |
| Policy contract number | L8474 |
| Policy instance | 5 |
| HEALTH NET (National Association of Insurance Commissioners NAIC id number: 95567 ) | |
| Policy contract number | BD184 |
| Policy instance | 8 |
| UDC DENTAL OF CALIFORNIA, INC. (National Association of Insurance Commissioners NAIC id number: 52031 ) | |
| Policy contract number | 5437064 |
| Policy instance | 9 |
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | 292975 |
| Policy instance | 10 |
| UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 ) | |
| Policy contract number | 5437064 |
| Policy instance | 3 |
| HEALTH NET (National Association of Insurance Commissioners NAIC id number: 95567 ) | |
| Policy contract number | BC961 |
| Policy instance | 1 |
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