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TRI COUNTY MENTAL HEALTH 401k Plan overview

Plan NameTRI COUNTY MENTAL HEALTH
Plan identification number 501

TRI COUNTY MENTAL HEALTH Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Vision
  • Long-term disability cover
  • Other welfare benefit cover
  • Unfunded, fully insured, or combination unfunded/insured welfare plan that will not file a Form 5500 for next plan year pursuant to 29 CFR 2520.104-20.
  • Unfunded, fully insured, or combination unfunded/insured welfare plan that stopped filing form 5500s in an earlier plan year pursuant to 29 CFR 2520.104-20.

401k Sponsoring company profile

TRI-COUNTY MENTAL HEALTH SERVICES, INC. has sponsored the creation of one or more 401k plans.

Company Name:TRI-COUNTY MENTAL HEALTH SERVICES, INC.
Employer identification number (EIN):431556416
NAIC Classification:621420
NAIC Description:Outpatient Mental Health and Substance Abuse Centers

Form 5500 Filing Information

Submission information for form 5500 for 401k plan TRI COUNTY MENTAL HEALTH

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012021-10-01
5012020-10-01CAROLYN WORTH2021-12-28
5012019-10-01CAROLYN WORTH2021-04-05
5012001-01-01CAROLYN WORTH2021-04-05

Plan Statistics for TRI COUNTY MENTAL HEALTH

401k plan membership statisitcs for TRI COUNTY MENTAL HEALTH

Measure Date Value
2021: TRI COUNTY MENTAL HEALTH 2021 401k membership
Total participants, beginning-of-year2021-10-01148
Total number of active participants reported on line 7a of the Form 55002021-10-01155
Number of retired or separated participants receiving benefits2021-10-010
Number of other retired or separated participants entitled to future benefits2021-10-010
Total of all active and inactive participants2021-10-01155
2020: TRI COUNTY MENTAL HEALTH 2020 401k membership
Total participants, beginning-of-year2020-10-01109
Total number of active participants reported on line 7a of the Form 55002020-10-01109
Number of retired or separated participants receiving benefits2020-10-010
Number of other retired or separated participants entitled to future benefits2020-10-010
Total of all active and inactive participants2020-10-01109
Number of employers contributing to the scheme2020-10-010
2019: TRI COUNTY MENTAL HEALTH 2019 401k membership
Total participants, beginning-of-year2019-10-0189
Total number of active participants reported on line 7a of the Form 55002019-10-01109
Number of retired or separated participants receiving benefits2019-10-010
Number of other retired or separated participants entitled to future benefits2019-10-010
Total of all active and inactive participants2019-10-01109
Number of employers contributing to the scheme2019-10-010
2001: TRI COUNTY MENTAL HEALTH 2001 401k membership
Total participants, beginning-of-year2001-01-0117
Total number of active participants reported on line 7a of the Form 55002001-01-0115
Number of retired or separated participants receiving benefits2001-01-010
Number of other retired or separated participants entitled to future benefits2001-01-010
Total of all active and inactive participants2001-01-0115
Number of employers contributing to the scheme2001-01-010

Form 5500 Responses for TRI COUNTY MENTAL HEALTH

2021: TRI COUNTY MENTAL HEALTH 2021 form 5500 responses
2021-10-01Type of plan entitySingle employer plan
2021-10-01Plan funding arrangement – InsuranceYes
2021-10-01Plan funding arrangement – General assets of the sponsorYes
2021-10-01Plan benefit arrangement – InsuranceYes
2021-10-01Plan benefit arrangement – General assets of the sponsorYes
2020: TRI COUNTY MENTAL HEALTH 2020 form 5500 responses
2020-10-01Type of plan entitySingle employer plan
2020-10-01Plan funding arrangement – General assets of the sponsorYes
2020-10-01Plan benefit arrangement – General assets of the sponsorYes
2019: TRI COUNTY MENTAL HEALTH 2019 form 5500 responses
2019-10-01Type of plan entitySingle employer plan
2019-10-01Plan funding arrangement – General assets of the sponsorYes
2019-10-01Plan benefit arrangement – General assets of the sponsorYes
2001: TRI COUNTY MENTAL HEALTH 2001 form 5500 responses
2001-01-01Type of plan entitySingle employer plan
2001-01-01Submission has been amendedYes
2001-01-01Plan funding arrangement – General assets of the sponsorYes
2001-01-01Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00565205
Policy instance 1
Insurance contract or identification number00565205
Number of Individuals Covered141
Insurance policy start date2021-10-01
Insurance policy end date2022-09-30
Total amount of commissions paid to insurance brokerUSD $12,704
Total amount of fees paid to insurance companyUSD $5,437
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $122,177
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,109
Amount paid for insurance broker fees4976
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3

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