401k Plan data: INTERCARE THERAPY, INC. VOLUNTARY BENEFITS PLAN plan

INTERCARE THERAPY, INC. VOLUNTARY BENEFITS PLAN 401k Plan overview

Plan Name	INTERCARE THERAPY, INC. VOLUNTARY BENEFITS PLAN
Plan identification number	502

INTERCARE THERAPY, INC. VOLUNTARY BENEFITS PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Other welfare benefit cover

401k Sponsoring company profile

INTERCARE THERAPY, INC. has sponsored the creation of one or more 401k plans.

Company Name: INTERCARE THERAPY, INC.

Employer identification number (EIN): 954749616

NAIC Classification: 621340
NAIC Description: Offices of Physical, Occupational and Speech Therapists, and Audiologists

Form 5500 Filing Information

Submission information for form 5500 for 401k plan INTERCARE THERAPY, INC. VOLUNTARY BENEFITS PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
502 2021-11-01
502 2020-11-01

Plan Statistics for INTERCARE THERAPY, INC. VOLUNTARY BENEFITS PLAN

401k plan membership statisitcs for INTERCARE THERAPY, INC. VOLUNTARY BENEFITS PLAN

Measure Date Value
2021: INTERCARE THERAPY, INC. VOLUNTARY BENEFITS PLAN 2021 401k membership
Total participants, beginning-of-year 2021-11-01 144
Total number of active participants reported on line 7a of the Form 5500 2021-11-01 182
Number of retired or separated participants receiving benefits 2021-11-01 0
Number of other retired or separated participants entitled to future benefits 2021-11-01 0
Total of all active and inactive participants 2021-11-01 182
2020: INTERCARE THERAPY, INC. VOLUNTARY BENEFITS PLAN 2020 401k membership
Total participants, beginning-of-year 2020-11-01 139
Total number of active participants reported on line 7a of the Form 5500 2020-11-01 144
Number of retired or separated participants receiving benefits 2020-11-01 0
Number of other retired or separated participants entitled to future benefits 2020-11-01 0
Total of all active and inactive participants 2020-11-01 144

Measure	Date	Value
2021: INTERCARE THERAPY, INC. VOLUNTARY BENEFITS PLAN 2021 401k membership
Total participants, beginning-of-year	2021-11-01	144
Total number of active participants reported on line 7a of the Form 5500	2021-11-01	182
Number of retired or separated participants receiving benefits	2021-11-01	0
Number of other retired or separated participants entitled to future benefits	2021-11-01	0
Total of all active and inactive participants	2021-11-01	182
2020: INTERCARE THERAPY, INC. VOLUNTARY BENEFITS PLAN 2020 401k membership
Total participants, beginning-of-year	2020-11-01	139
Total number of active participants reported on line 7a of the Form 5500	2020-11-01	144
Number of retired or separated participants receiving benefits	2020-11-01	0
Number of other retired or separated participants entitled to future benefits	2020-11-01	0
Total of all active and inactive participants	2020-11-01	144

Form 5500 Responses for INTERCARE THERAPY, INC. VOLUNTARY BENEFITS PLAN

2021: INTERCARE THERAPY, INC. VOLUNTARY BENEFITS PLAN 2021 form 5500 responses
2021-11-01	Type of plan entity	Single employer plan
2021-11-01	Submission has been amended	No
2021-11-01	This submission is the final filing	No
2021-11-01	This return/report is a short plan year return/report (less than 12 months)	No
2021-11-01	Plan is a collectively bargained plan	No
2021-11-01	Plan funding arrangement – Insurance	Yes
2021-11-01	Plan benefit arrangement – Insurance	Yes
2020: INTERCARE THERAPY, INC. VOLUNTARY BENEFITS PLAN 2020 form 5500 responses
2020-11-01	Type of plan entity	Single employer plan
2020-11-01	First time form 5500 has been submitted	Yes
2020-11-01	Submission has been amended	No
2020-11-01	This submission is the final filing	No
2020-11-01	This return/report is a short plan year return/report (less than 12 months)	No
2020-11-01	Plan is a collectively bargained plan	No
2020-11-01	Plan funding arrangement – General assets of the sponsor	Yes
2020-11-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )

Policy contract number

00565623

Policy instance

Insurance contract or identification number	00565623
Number of Individuals Covered	182
Insurance policy start date	2021-11-01
Insurance policy end date	2022-10-31
Total amount of commissions paid to insurance broker	USD $26,144
Total amount of fees paid to insurance company	USD $3,646
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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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 Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Other welfare benefits provided	ACCIDENT, CRITICAL ILLNESS, HOSPITAL INDEMNITY
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 Carrier	USD $70,925
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $15,819
Insurance broker organization code?	3
Amount paid for insurance broker fees	3646
Additional information about fees paid to insurance broker	BROKER FEES

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )

Policy contract number

00565623

Policy instance

Insurance contract or identification number	00565623
Number of Individuals Covered	144
Insurance policy start date	2020-11-01
Insurance policy end date	2021-10-31
Total amount of commissions paid to insurance broker	USD $21,707
Total amount of fees paid to insurance company	USD $5,085
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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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 Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Other welfare benefits provided	ACCIDENT, CRITICAL ILLNESS, HOSPITAL INDEMNITY
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 Carrier	USD $62,775
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $8,710
Amount paid for insurance broker fees	5085
Additional information about fees paid to insurance broker	BROKER FEES
Insurance broker organization code?	3

Potentially related plans

INTERCARE THERAPY, INC. PROFIT SHARING PLAN [EIN = 811206867]

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Company Name:	INTERCARE THERAPY, INC.
Employer identification number (EIN):	954749616
NAIC Classification:	621340
NAIC Description:	Offices of Physical, Occupational and Speech Therapists, and Audiologists