401k Plan data: ALOHACARE plan

ALOHACARE 401k Plan overview

Plan Name	ALOHACARE
Plan identification number	561

ALOHACARE Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) Vision

401k Sponsoring company profile

ALOHACARE has sponsored the creation of one or more 401k plans.

Company Name: ALOHACARE

Employer identification number (EIN): 990309519

NAIC Classification: 524140

Additional information about ALOHACARE

Jurisdiction of Incorporation: Texas Secretary of State

Incorporation Date: 2017-03-01

Company Identification Number: 0802663590

Legal Registered Office Address: 1601 ELM ST STE 4360

DALLAS
United States of America (USA)
75201

More information about ALOHACARE

Form 5500 Filing Information

Submission information for form 5500 for 401k plan ALOHACARE

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
561 2021-01-01

Plan Statistics for ALOHACARE

401k plan membership statisitcs for ALOHACARE

Measure Date Value
2021: ALOHACARE 2021 401k membership
Total participants, beginning-of-year 2021-01-01 178
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 270
Total of all active and inactive participants 2021-01-01 270
Total participants 2021-01-01 270

Measure	Date	Value
2021: ALOHACARE 2021 401k membership
Total participants, beginning-of-year	2021-01-01	178
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	270
Total of all active and inactive participants	2021-01-01	270
Total participants	2021-01-01	270

Form 5500 Responses for ALOHACARE

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

Insurance Providers Used on plan

UNIVERSITY HEALTH ALLIANCE (National Association of Insurance Commissioners NAIC id number: 47953 )

Policy contract number

8356

Policy instance

Insurance contract or identification number	8356
Number of Individuals Covered	270
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Total amount of fees paid to insurance company	USD $218,405
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	Yes
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	Yes
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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Company Name:	ALOHACARE
Employer identification number (EIN):	990309519
NAIC Classification:	524140

Jurisdiction of Incorporation:	Texas Secretary of State
Incorporation Date:	2017-03-01
Company Identification Number:	0802663590
Legal Registered Office Address:	1601 ELM ST STE 4360 DALLAS United States of America (USA) 75201