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| Plan Name | COMMUNITY PARTNERS WELFARE BENEFIT PLAN |
| Plan identification number | 506 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | BEHAVIORAL HEALTH & DEVELOPMENTAL SERVICES OF STRAFFORD COUNTY, INC. |
| Employer identification number (EIN): | 020366120 |
| NAIC Classification: | 624100 |
| NAIC Description: | Individual and Family Services |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 506 | 2023-01-01 | LESLIE BISOGNANI | 2024-08-06 |
| 2023: COMMUNITY PARTNERS WELFARE BENEFIT PLAN 2023 form 5500 responses | ||
|---|---|---|
| 2023-01-01 | Type of plan entity | Single employer plan |
| 2023-01-01 | First time form 5500 has been submitted | Yes |
| 2023-01-01 | Plan funding arrangement – Insurance | Yes |
| 2023-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2023-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2023-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| MATTHEW THORNTON HEALTH PLAN INC. (National Association of Insurance Commissioners NAIC id number: 95527 ) | |||||||||||||||||||||||||
| Policy contract number | 364108 | ||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||
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| ANTHEM HEALTH PLANS OF NEW HAMPSHIRE, INC. (National Association of Insurance Commissioners NAIC id number: 53759 ) | |||||||||||||||||||||||||
| Policy contract number | 364108 | ||||||||||||||||||||||||
| Policy instance | 2 | ||||||||||||||||||||||||
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| ANTHEM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61069 ) | |||||||||||||||||||||||||
| Policy contract number | AL00005659 | ||||||||||||||||||||||||
| Policy instance | 3 | ||||||||||||||||||||||||
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