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COMMUNITY HEALTH ALLIANCE EMPLOYEES' RETIREMENT PLAN 401k Plan overview

Plan NameCOMMUNITY HEALTH ALLIANCE EMPLOYEES' RETIREMENT PLAN
Plan identification number 001

COMMUNITY HEALTH ALLIANCE EMPLOYEES' RETIREMENT PLAN Benefits

401k Plan TypeDefined Contribution Pension
Plan Features/Benefits
  • Profit-sharing
  • ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
  • Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
  • Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
  • Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
  • Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.

401k Sponsoring company profile

COMMUNITY HEALTH ALLIANCE MUTUAL INSURANCE COMPANY has sponsored the creation of one or more 401k plans.

Company Name:COMMUNITY HEALTH ALLIANCE MUTUAL INSURANCE COMPANY
Employer identification number (EIN):453127905
NAIC Classification:524290

Form 5500 Filing Information

Submission information for form 5500 for 401k plan COMMUNITY HEALTH ALLIANCE EMPLOYEES' RETIREMENT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012016-01-01
0012015-01-01
0012014-01-01MARK OWENS2015-10-14
0012013-06-01M EVANS ON BEHALF OF PLAN ADMIN2014-07-22

Plan Statistics for COMMUNITY HEALTH ALLIANCE EMPLOYEES' RETIREMENT PLAN

401k plan membership statisitcs for COMMUNITY HEALTH ALLIANCE EMPLOYEES' RETIREMENT PLAN

Measure Date Value
2016: COMMUNITY HEALTH ALLIANCE EMPLOYEES' RETIREMENT PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-01173
Total number of active participants reported on line 7a of the Form 55002016-01-010
Number of retired or separated participants receiving benefits2016-01-010
Number of other retired or separated participants entitled to future benefits2016-01-010
Total of all active and inactive participants2016-01-010
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2016-01-010
Total participants2016-01-010
Number of participants with account balances2016-01-010
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2016-01-010

Financial Data on COMMUNITY HEALTH ALLIANCE EMPLOYEES' RETIREMENT PLAN

Measure Date Value
2016 : COMMUNITY HEALTH ALLIANCE EMPLOYEES' RETIREMENT PLAN 2016 401k financial data
Total unrealized appreciation/depreciation of assets2016-12-02$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-02$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-02$0
Total income from all sources (including contributions)2016-12-02$293,244
Total loss/gain on sale of assets2016-12-02$0
Total of all expenses incurred2016-12-02$1,114,486
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2016-12-02$1,105,021
Total contributions o plan (from employers,participants, others, non cash contrinutions)2016-12-02$265,211
Value of total assets at end of year2016-12-02$0
Value of total assets at beginning of year2016-12-02$821,242
Total of administrative expenses incurred including professional, contract, advisory and management fees2016-12-02$9,465
Total interest from all sources2016-12-02$0
Total dividends received (eg from common stock, registered investment company shares)2016-12-02$2,285
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2016-12-02Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan2016-12-02$0
Total dividends received from registered investment company shares (eg mutual funds)2016-12-02$2,285
Administrative expenses professional fees incurred2016-12-02$9,465
Was this plan covered by a fidelity bond2016-12-02Yes
Value of fidelity bond cover2016-12-02$1,000,000
If this is an individual account plan, was there a blackout period2016-12-02No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2016-12-02$0
Were there any nonexempt tranactions with any party-in-interest2016-12-02No
Contributions received from participants2016-12-02$141,399
Total non interest bearing cash at end of year2016-12-02$0
Total non interest bearing cash at beginning of year2016-12-02$16,219
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-02No
Value of net income/loss2016-12-02$-821,242
Value of net assets at end of year (total assets less liabilities)2016-12-02$0
Value of net assets at beginning of year (total assets less liabilities)2016-12-02$821,242
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2016-12-02No
Were any loans by the plan or fixed income obligations due to the plan in default2016-12-02No
Were any leases to which the plan was party in default or uncollectible2016-12-02No
Value of interest in registered invesment companies (eg mutual funds) at end of year2016-12-02$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2016-12-02$785,205
Value of interest in common/collective trusts at end of year2016-12-02$0
Value of interest in common/collective trusts at beginning of year2016-12-02$19,818
Net investment gain/loss from registered investment companies (e.g. mutual funds)2016-12-02$25,748
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2016-12-02No
Was there a failure to transmit to the plan any participant contributions2016-12-02No
Has the plan failed to provide any benefit when due under the plan2016-12-02No
Contributions received in cash from employer2016-12-02$123,812
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2016-12-02$1,105,021
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32016-12-02No
Did the plan have assets held for investment2016-12-02No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-02No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2016-12-02Yes
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2016-12-02Yes
Opinion of an independent qualified public accountant for this plan2016-12-02Disclaimer
Accountancy firm name2016-12-02LBMC, P.C.
Accountancy firm EIN2016-12-02621199757

Form 5500 Responses for COMMUNITY HEALTH ALLIANCE EMPLOYEES' RETIREMENT PLAN

2016: COMMUNITY HEALTH ALLIANCE EMPLOYEES' RETIREMENT PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Submission has been amendedNo
2016-01-01This submission is the final filingYes
2016-01-01This return/report is a short plan year return/report (less than 12 months)Yes
2016-01-01Plan is a collectively bargained planNo
2016-01-01Plan funding arrangement – TrustYes
2016-01-01Plan benefit arrangement - TrustYes

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