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NORTH METRO COMMUNITY SERVICES HEALTH PLAN 401k Plan overview

Plan NameNORTH METRO COMMUNITY SERVICES HEALTH PLAN
Plan identification number 503

NORTH METRO COMMUNITY SERVICES HEALTH PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Vision
  • Long-term disability cover
  • Death benefits (include travel accident but not life insurance)
  • Other welfare benefit cover

401k Sponsoring company profile

NORTH METRO COMMUNITY SERVICES INC. has sponsored the creation of one or more 401k plans.

Company Name:NORTH METRO COMMUNITY SERVICES INC.
Employer identification number (EIN):840534757
NAIC Classification:624200

Form 5500 Filing Information

Submission information for form 5500 for 401k plan NORTH METRO COMMUNITY SERVICES HEALTH PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5032023-07-01JENNIFER O'SHEA2024-11-11
5032022-07-01JENNIFER O'SHEA2024-02-14
5032021-07-01JENNIFER O'SHEA2022-11-07
5032020-07-01JENNIFER O'SHEA2022-01-19
5032019-07-01JENNIFER O'SHEA2020-12-03
5032017-07-01JENNIFER O'SHEA
5032016-07-01JENNIFER O'SHEA
5032015-07-01JENNIFER OSHEA JENNIFER OSHEA2017-01-31
5032013-07-01JENNIFER O'SHEA
5032012-07-01JENNIFER O'SHEA
5032011-07-01JENNIFER O'SHEA
5032010-07-01JENNIFER O'SHEA
5032009-07-01JENNIFER O'SHEA

Plan Statistics for NORTH METRO COMMUNITY SERVICES HEALTH PLAN

401k plan membership statisitcs for NORTH METRO COMMUNITY SERVICES HEALTH PLAN

Measure Date Value
2023: NORTH METRO COMMUNITY SERVICES HEALTH PLAN 2023 401k membership
Total participants, beginning-of-year2023-07-01188
Total number of active participants reported on line 7a of the Form 55002023-07-01149
Number of retired or separated participants receiving benefits2023-07-010
Number of other retired or separated participants entitled to future benefits2023-07-010
Total of all active and inactive participants2023-07-01149
Number of employers contributing to the scheme2023-07-010
2022: NORTH METRO COMMUNITY SERVICES HEALTH PLAN 2022 401k membership
Total participants, beginning-of-year2022-07-01183
Total number of active participants reported on line 7a of the Form 55002022-07-01188
Number of retired or separated participants receiving benefits2022-07-010
Number of other retired or separated participants entitled to future benefits2022-07-010
Total of all active and inactive participants2022-07-01188
Number of employers contributing to the scheme2022-07-010
2021: NORTH METRO COMMUNITY SERVICES HEALTH PLAN 2021 401k membership
Total participants, beginning-of-year2021-07-01200
Total number of active participants reported on line 7a of the Form 55002021-07-01183
Number of retired or separated participants receiving benefits2021-07-010
Number of other retired or separated participants entitled to future benefits2021-07-010
Total of all active and inactive participants2021-07-01183
Number of employers contributing to the scheme2021-07-010
2020: NORTH METRO COMMUNITY SERVICES HEALTH PLAN 2020 401k membership
Total participants, beginning-of-year2020-07-01256
Total number of active participants reported on line 7a of the Form 55002020-07-01200
Number of retired or separated participants receiving benefits2020-07-010
Number of other retired or separated participants entitled to future benefits2020-07-010
Total of all active and inactive participants2020-07-01200
Number of employers contributing to the scheme2020-07-010
2019: NORTH METRO COMMUNITY SERVICES HEALTH PLAN 2019 401k membership
Total participants, beginning-of-year2019-07-01241
Total number of active participants reported on line 7a of the Form 55002019-07-01256
Number of retired or separated participants receiving benefits2019-07-010
Number of other retired or separated participants entitled to future benefits2019-07-010
Total of all active and inactive participants2019-07-01256
Number of employers contributing to the scheme2019-07-010
2017: NORTH METRO COMMUNITY SERVICES HEALTH PLAN 2017 401k membership
Total participants, beginning-of-year2017-07-01232
Total number of active participants reported on line 7a of the Form 55002017-07-01226
Number of retired or separated participants receiving benefits2017-07-012
Number of other retired or separated participants entitled to future benefits2017-07-010
Total of all active and inactive participants2017-07-01228
2016: NORTH METRO COMMUNITY SERVICES HEALTH PLAN 2016 401k membership
Total participants, beginning-of-year2016-07-01244
Total number of active participants reported on line 7a of the Form 55002016-07-01232
Number of retired or separated participants receiving benefits2016-07-010
Number of other retired or separated participants entitled to future benefits2016-07-010
Total of all active and inactive participants2016-07-01232
2015: NORTH METRO COMMUNITY SERVICES HEALTH PLAN 2015 401k membership
Total participants, beginning-of-year2015-07-01263
Total number of active participants reported on line 7a of the Form 55002015-07-01242
Number of retired or separated participants receiving benefits2015-07-012
Total of all active and inactive participants2015-07-01244
2013: NORTH METRO COMMUNITY SERVICES HEALTH PLAN 2013 401k membership
Total participants, beginning-of-year2013-07-01229
Total number of active participants reported on line 7a of the Form 55002013-07-01259
Total of all active and inactive participants2013-07-01259
Total participants2013-07-010
2012: NORTH METRO COMMUNITY SERVICES HEALTH PLAN 2012 401k membership
Total participants, beginning-of-year2012-07-01238
Total number of active participants reported on line 7a of the Form 55002012-07-01229
Total of all active and inactive participants2012-07-01229
Total participants2012-07-010
2011: NORTH METRO COMMUNITY SERVICES HEALTH PLAN 2011 401k membership
Total participants, beginning-of-year2011-07-01246
Total number of active participants reported on line 7a of the Form 55002011-07-01238
Total of all active and inactive participants2011-07-01238
Total participants2011-07-01238
2010: NORTH METRO COMMUNITY SERVICES HEALTH PLAN 2010 401k membership
Total participants, beginning-of-year2010-07-01236
Total number of active participants reported on line 7a of the Form 55002010-07-01246
Total of all active and inactive participants2010-07-01246
Total participants2010-07-01246
2009: NORTH METRO COMMUNITY SERVICES HEALTH PLAN 2009 401k membership
Total participants, beginning-of-year2009-07-01231
Total number of active participants reported on line 7a of the Form 55002009-07-01236
Total of all active and inactive participants2009-07-01236
Total participants2009-07-01236

Form 5500 Responses for NORTH METRO COMMUNITY SERVICES HEALTH PLAN

2023: NORTH METRO COMMUNITY SERVICES HEALTH PLAN 2023 form 5500 responses
2023-07-01Type of plan entitySingle employer plan
2023-07-01Plan funding arrangement – InsuranceYes
2023-07-01Plan funding arrangement – General assets of the sponsorYes
2023-07-01Plan benefit arrangement – InsuranceYes
2023-07-01Plan benefit arrangement – General assets of the sponsorYes
2022: NORTH METRO COMMUNITY SERVICES HEALTH PLAN 2022 form 5500 responses
2022-07-01Type of plan entitySingle employer plan
2022-07-01Plan funding arrangement – InsuranceYes
2022-07-01Plan funding arrangement – General assets of the sponsorYes
2022-07-01Plan benefit arrangement – InsuranceYes
2022-07-01Plan benefit arrangement – General assets of the sponsorYes
2021: NORTH METRO COMMUNITY SERVICES HEALTH PLAN 2021 form 5500 responses
2021-07-01Type of plan entitySingle employer plan
2021-07-01Plan funding arrangement – InsuranceYes
2021-07-01Plan funding arrangement – General assets of the sponsorYes
2021-07-01Plan benefit arrangement – InsuranceYes
2021-07-01Plan benefit arrangement – General assets of the sponsorYes
2020: NORTH METRO COMMUNITY SERVICES HEALTH PLAN 2020 form 5500 responses
2020-07-01Type of plan entitySingle employer plan
2020-07-01Plan funding arrangement – InsuranceYes
2020-07-01Plan funding arrangement – General assets of the sponsorYes
2020-07-01Plan benefit arrangement – InsuranceYes
2020-07-01Plan benefit arrangement – General assets of the sponsorYes
2019: NORTH METRO COMMUNITY SERVICES HEALTH PLAN 2019 form 5500 responses
2019-07-01Type of plan entitySingle employer plan
2019-07-01Plan funding arrangement – InsuranceYes
2019-07-01Plan funding arrangement – General assets of the sponsorYes
2019-07-01Plan benefit arrangement – InsuranceYes
2019-07-01Plan benefit arrangement – General assets of the sponsorYes
2017: NORTH METRO COMMUNITY SERVICES HEALTH PLAN 2017 form 5500 responses
2017-07-01Type of plan entitySingle employer plan
2017-07-01Submission has been amendedNo
2017-07-01This submission is the final filingNo
2017-07-01This return/report is a short plan year return/report (less than 12 months)No
2017-07-01Plan is a collectively bargained planNo
2017-07-01Plan funding arrangement – InsuranceYes
2017-07-01Plan benefit arrangement – InsuranceYes
2016: NORTH METRO COMMUNITY SERVICES HEALTH PLAN 2016 form 5500 responses
2016-07-01Type of plan entitySingle employer plan
2016-07-01Submission has been amendedNo
2016-07-01This submission is the final filingNo
2016-07-01This return/report is a short plan year return/report (less than 12 months)No
2016-07-01Plan is a collectively bargained planNo
2016-07-01Plan funding arrangement – InsuranceYes
2016-07-01Plan benefit arrangement – InsuranceYes
2015: NORTH METRO COMMUNITY SERVICES HEALTH PLAN 2015 form 5500 responses
2015-07-01Type of plan entitySingle employer plan
2015-07-01Submission has been amendedNo
2015-07-01This submission is the final filingNo
2015-07-01This return/report is a short plan year return/report (less than 12 months)No
2015-07-01Plan is a collectively bargained planNo
2015-07-01Plan funding arrangement – InsuranceYes
2015-07-01Plan benefit arrangement – InsuranceYes
2013: NORTH METRO COMMUNITY SERVICES HEALTH PLAN 2013 form 5500 responses
2013-07-01Type of plan entitySingle employer plan
2013-07-01Plan funding arrangement – InsuranceYes
2013-07-01Plan benefit arrangement – InsuranceYes
2012: NORTH METRO COMMUNITY SERVICES HEALTH PLAN 2012 form 5500 responses
2012-07-01Type of plan entitySingle employer plan
2012-07-01Plan funding arrangement – InsuranceYes
2012-07-01Plan benefit arrangement – InsuranceYes
2011: NORTH METRO COMMUNITY SERVICES HEALTH PLAN 2011 form 5500 responses
2011-07-01Type of plan entitySingle employer plan
2011-07-01Plan funding arrangement – InsuranceYes
2011-07-01Plan benefit arrangement – InsuranceYes
2010: NORTH METRO COMMUNITY SERVICES HEALTH PLAN 2010 form 5500 responses
2010-07-01Type of plan entitySingle employer plan
2010-07-01Plan funding arrangement – InsuranceYes
2010-07-01Plan benefit arrangement – InsuranceYes
2009: NORTH METRO COMMUNITY SERVICES HEALTH PLAN 2009 form 5500 responses
2009-07-01Type of plan entitySingle employer plan
2009-07-01Plan funding arrangement – InsuranceYes
2009-07-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number10262297
Policy instance 4
Insurance contract or identification number10262297
Number of Individuals Covered149
Insurance policy start date2023-07-01
Insurance policy end date2024-06-30
Total amount of commissions paid to insurance brokerUSD $25
Total amount of fees paid to insurance companyUSD $704
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT, EMPLOYEE ASSISTANCE PROGRAM
Welfare Benefit Premiums Paid to CarrierUSD $39,141
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number10176601001
Policy instance 3
Insurance contract or identification number10176601001
Number of Individuals Covered161
Insurance policy start date2023-07-01
Insurance policy end date2024-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $8,587
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number3342777
Policy instance 2
Insurance contract or identification number3342777
Number of Individuals Covered123
Insurance policy start date2023-07-01
Insurance policy end date2024-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $628
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $53,763
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
KAISER FOUNDATION HEALTH PLAN OF COLORADO (National Association of Insurance Commissioners NAIC id number: 95669 )
Policy contract number35821
Policy instance 1
Insurance contract or identification number35821
Number of Individuals Covered159
Insurance policy start date2023-07-01
Insurance policy end date2024-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,176,906
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
KAISER FOUNDATION HEALTH PLAN OF COLORADO (National Association of Insurance Commissioners NAIC id number: 95669 )
Policy contract number35821
Policy instance 1
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number3342777
Policy instance 2
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number10176601001
Policy instance 3
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number10262297
Policy instance 4
KAISER FOUNDATION HEALTH PLAN OF COLORADO (National Association of Insurance Commissioners NAIC id number: 95669 )
Policy contract number35821
Policy instance 1
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number3342777
Policy instance 2
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number10176601001
Policy instance 3
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number10262297
Policy instance 4
KAISER FOUNDATION HEALTH PLAN OF COLORADO (National Association of Insurance Commissioners NAIC id number: 95669 )
Policy contract number35821
Policy instance 1
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number3342777
Policy instance 2
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number10176601001
Policy instance 3
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number10262297
Policy instance 4
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number885380G
Policy instance 4
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number10176601001
Policy instance 3
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number3342777
Policy instance 2
KAISER FOUNDATION HEALTH PLAN OF COLORADO (National Association of Insurance Commissioners NAIC id number: 95669 )
Policy contract number35821
Policy instance 1
KAISER FOUNDATION HEALTH PLAN OF COLORADO (National Association of Insurance Commissioners NAIC id number: 95669 )
Policy contract number35821
Policy instance 1
CIGNA DENTAL HEALTH PLAN OF COLORADO, INC. (National Association of Insurance Commissioners NAIC id number: 11175 )
Policy contract number0609281
Policy instance 6
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberOK 968906
Policy instance 5
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberLK 965068
Policy instance 4
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberFLX967387
Policy instance 3
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number0609281
Policy instance 2
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number0804601
Policy instance 1
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number0609281
Policy instance 2
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000010129958
Policy instance 3
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number00609281
Policy instance 4
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number0609281
Policy instance 2
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000010177058
Policy instance 1
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number132460
Policy instance 3
HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 )
Policy contract number542554
Policy instance 2
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000010129958
Policy instance 1
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000010129958
Policy instance 1
HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 )
Policy contract number542554
Policy instance 2
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number132460
Policy instance 3
HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 )
Policy contract number542554
Policy instance 2
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number132460
Policy instance 3
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000010129958
Policy instance 1

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