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COMMUNITY OPTIONS MEDICAL BENEFITS PLAN 401k Plan overview

Plan NameCOMMUNITY OPTIONS MEDICAL BENEFITS PLAN
Plan identification number 501

COMMUNITY OPTIONS MEDICAL BENEFITS PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance

401k Sponsoring company profile

COMMUNITY CPTIONS, INC. has sponsored the creation of one or more 401k plans.

Company Name:COMMUNITY CPTIONS, INC.
Employer identification number (EIN):840626085
NAIC Classification:623000
NAIC Description: Nursing and Residential Care Facilities

Additional information about COMMUNITY CPTIONS, INC.

Jurisdiction of Incorporation: Colorado Department of State
Incorporation Date: 1972-06-23
Company Identification Number: 19871281624
Legal Registered Office Address: 936 N Park Ave

Montrose
United States of America (USA)
81401

More information about COMMUNITY CPTIONS, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan COMMUNITY OPTIONS MEDICAL BENEFITS PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012016-07-01STEVE DAHLMAN STEVE DAHLMAN2018-02-02
5012015-07-01STEVE DAHLMAN STEVE DAHLMAN2017-01-25
5012014-07-01STEVE DAHLMAN
5012013-07-01STEVE DAHLMAN STEVE DAHLMAN2014-12-18
5012012-07-01STEVE DAHLMAN STEVE DAHLMAN2014-01-15
5012011-07-01STEVE DAHLMAN STEVE DAHLMAN2013-04-13
5012009-07-01STEVE DAHLMAN STEVE DAHLMAN2013-05-24
5012008-07-01STEVE DAHLMAN
5012007-07-01STEVE DAHLMAN
5012006-07-01STEVE DAHLMAN

Plan Statistics for COMMUNITY OPTIONS MEDICAL BENEFITS PLAN

401k plan membership statisitcs for COMMUNITY OPTIONS MEDICAL BENEFITS PLAN

Measure Date Value
2016: COMMUNITY OPTIONS MEDICAL BENEFITS PLAN 2016 401k membership
Total participants, beginning-of-year2016-07-0176
Total number of active participants reported on line 7a of the Form 55002016-07-0172
Total of all active and inactive participants2016-07-0172
Total participants2016-07-0172
2015: COMMUNITY OPTIONS MEDICAL BENEFITS PLAN 2015 401k membership
Total participants, beginning-of-year2015-07-0184
Total number of active participants reported on line 7a of the Form 55002015-07-0176
Total of all active and inactive participants2015-07-0176
Total participants2015-07-0176
2014: COMMUNITY OPTIONS MEDICAL BENEFITS PLAN 2014 401k membership
Total participants, beginning-of-year2014-07-0179
Total number of active participants reported on line 7a of the Form 55002014-07-0184
Total of all active and inactive participants2014-07-0184
Total participants2014-07-0184
2013: COMMUNITY OPTIONS MEDICAL BENEFITS PLAN 2013 401k membership
Total participants, beginning-of-year2013-07-01100
Total number of active participants reported on line 7a of the Form 55002013-07-0179
Number of retired or separated participants receiving benefits2013-07-010
Number of other retired or separated participants entitled to future benefits2013-07-010
Total of all active and inactive participants2013-07-0179
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-07-010
Total participants2013-07-0179
2012: COMMUNITY OPTIONS MEDICAL BENEFITS PLAN 2012 401k membership
Total participants, beginning-of-year2012-07-0191
Total number of active participants reported on line 7a of the Form 55002012-07-0198
Number of retired or separated participants receiving benefits2012-07-012
Total of all active and inactive participants2012-07-01100
Total participants2012-07-01100
2011: COMMUNITY OPTIONS MEDICAL BENEFITS PLAN 2011 401k membership
Total participants, beginning-of-year2011-07-01116
Total number of active participants reported on line 7a of the Form 55002011-07-0191
Total of all active and inactive participants2011-07-0191
Total participants2011-07-0191
2009: COMMUNITY OPTIONS MEDICAL BENEFITS PLAN 2009 401k membership
Total participants, beginning-of-year2009-07-01119
Total number of active participants reported on line 7a of the Form 55002009-07-01122
Total of all active and inactive participants2009-07-01122
Total participants2009-07-01122
2008: COMMUNITY OPTIONS MEDICAL BENEFITS PLAN 2008 401k membership
Total participants, beginning-of-year2008-07-01111
Total number of active participants reported on line 7a of the Form 55002008-07-01119
Total of all active and inactive participants2008-07-01119
Total participants2008-07-01119
2007: COMMUNITY OPTIONS MEDICAL BENEFITS PLAN 2007 401k membership
Total participants, beginning-of-year2007-07-01101
Total number of active participants reported on line 7a of the Form 55002007-07-01111
Total of all active and inactive participants2007-07-01111
Total participants2007-07-01111
2006: COMMUNITY OPTIONS MEDICAL BENEFITS PLAN 2006 401k membership
Total participants, beginning-of-year2006-07-01107
Total number of active participants reported on line 7a of the Form 55002006-07-01101
Total of all active and inactive participants2006-07-01101
Total participants2006-07-01101

Form 5500 Responses for COMMUNITY OPTIONS MEDICAL BENEFITS PLAN

2016: COMMUNITY OPTIONS MEDICAL BENEFITS PLAN 2016 form 5500 responses
2016-07-01Type of plan entitySingle employer plan
2016-07-01First time form 5500 has been submittedYes
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: COMMUNITY OPTIONS MEDICAL BENEFITS PLAN 2015 form 5500 responses
2015-07-01Type of plan entitySingle employer plan
2015-07-01First time form 5500 has been submittedYes
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
2014: COMMUNITY OPTIONS MEDICAL BENEFITS PLAN 2014 form 5500 responses
2014-07-01Type of plan entitySingle employer plan
2014-07-01First time form 5500 has been submittedYes
2014-07-01Submission has been amendedNo
2014-07-01This submission is the final filingNo
2014-07-01This return/report is a short plan year return/report (less than 12 months)No
2014-07-01Plan is a collectively bargained planNo
2014-07-01Plan funding arrangement – InsuranceYes
2014-07-01Plan benefit arrangement – InsuranceYes
2013: COMMUNITY OPTIONS MEDICAL BENEFITS PLAN 2013 form 5500 responses
2013-07-01Type of plan entitySingle employer plan
2013-07-01First time form 5500 has been submittedYes
2013-07-01Submission has been amendedNo
2013-07-01This submission is the final filingNo
2013-07-01This return/report is a short plan year return/report (less than 12 months)No
2013-07-01Plan is a collectively bargained planNo
2013-07-01Plan funding arrangement – InsuranceYes
2013-07-01Plan benefit arrangement – InsuranceYes
2012: COMMUNITY OPTIONS MEDICAL BENEFITS PLAN 2012 form 5500 responses
2012-07-01Type of plan entitySingle employer plan
2012-07-01First time form 5500 has been submittedYes
2012-07-01Submission has been amendedNo
2012-07-01This submission is the final filingNo
2012-07-01This return/report is a short plan year return/report (less than 12 months)No
2012-07-01Plan is a collectively bargained planNo
2012-07-01Plan funding arrangement – InsuranceYes
2012-07-01Plan benefit arrangement – InsuranceYes
2011: COMMUNITY OPTIONS MEDICAL BENEFITS PLAN 2011 form 5500 responses
2011-07-01Type of plan entitySingle employer plan
2011-07-01First time form 5500 has been submittedYes
2011-07-01Submission has been amendedNo
2011-07-01This submission is the final filingNo
2011-07-01This return/report is a short plan year return/report (less than 12 months)No
2011-07-01Plan is a collectively bargained planNo
2011-07-01Plan funding arrangement – InsuranceYes
2011-07-01Plan benefit arrangement – InsuranceYes
2009: COMMUNITY OPTIONS MEDICAL BENEFITS PLAN 2009 form 5500 responses
2009-07-01Type of plan entitySingle employer plan
2009-07-01First time form 5500 has been submittedYes
2009-07-01Submission has been amendedNo
2009-07-01This submission is the final filingNo
2009-07-01This return/report is a short plan year return/report (less than 12 months)No
2009-07-01Plan is a collectively bargained planNo
2009-07-01Plan funding arrangement – InsuranceYes
2009-07-01Plan benefit arrangement – InsuranceYes
2008: COMMUNITY OPTIONS MEDICAL BENEFITS PLAN 2008 form 5500 responses
2008-07-01Type of plan entitySingle employer plan
2008-07-01Submission has been amendedNo
2008-07-01This submission is the final filingNo
2008-07-01This return/report is a short plan year return/report (less than 12 months)No
2008-07-01Plan is a collectively bargained planNo
2008-07-01Plan funding arrangement – InsuranceYes
2008-07-01Plan benefit arrangement – InsuranceYes
2007: COMMUNITY OPTIONS MEDICAL BENEFITS PLAN 2007 form 5500 responses
2007-07-01Type of plan entitySingle employer plan
2007-07-01Submission has been amendedNo
2007-07-01This submission is the final filingNo
2007-07-01This return/report is a short plan year return/report (less than 12 months)No
2007-07-01Plan is a collectively bargained planNo
2007-07-01Plan funding arrangement – InsuranceYes
2007-07-01Plan benefit arrangement – InsuranceYes
2006: COMMUNITY OPTIONS MEDICAL BENEFITS PLAN 2006 form 5500 responses
2006-07-01Type of plan entitySingle employer plan
2006-07-01Submission has been amendedNo
2006-07-01This submission is the final filingNo
2006-07-01This return/report is a short plan year return/report (less than 12 months)No
2006-07-01Plan is a collectively bargained planNo
2006-07-01Plan funding arrangement – InsuranceYes
2006-07-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

ROCKY MOUNTAIN HOSPITAL AND MEDICAL SERVICE, INC. (National Association of Insurance Commissioners NAIC id number: 11011 )
Policy contract number195935
Policy instance 1
Insurance contract or identification number195935
Number of Individuals Covered76
Insurance policy start date2015-07-01
Insurance policy end date2016-06-30
Total amount of commissions paid to insurance brokerUSD $26,768
Total amount of fees paid to insurance companyUSD $126
Are there contracts with allocated funds for individual policies?No
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $621,273
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $26,768
Amount paid for insurance broker fees126
Additional information about fees paid to insurance brokerINCENTIVES EDUCATION, COMMUNICATION AND TRAINING
Insurance broker organization code?3
Insurance broker nameIMA INC
ROCKY MOUNTAIN HOSPITAL AND MEDICAL SERVICE, INC. (National Association of Insurance Commissioners NAIC id number: 11011 )
Policy contract number195935
Policy instance 1
Insurance contract or identification number195935
Number of Individuals Covered84
Insurance policy start date2014-07-01
Insurance policy end date2015-06-30
Total amount of commissions paid to insurance brokerUSD $28,672
Total amount of fees paid to insurance companyUSD $368
Are there contracts with allocated funds for individual policies?No
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $630,790
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $28,762
Amount paid for insurance broker fees368
Additional information about fees paid to insurance brokerINCENTIVES, EDUCATION, COMMUNICATION AND TRAINING
Insurance broker organization code?3
Insurance broker nameIMA INC
ROCKY MOUNTAIN HOSPITAL AND MEDICAL SERVICE, INC. (National Association of Insurance Commissioners NAIC id number: 11011 )
Policy contract number195935
Policy instance 1
Insurance contract or identification number195935
Number of Individuals Covered82
Insurance policy start date2013-07-01
Insurance policy end date2014-06-30
Total amount of commissions paid to insurance brokerUSD $30,044
Total amount of fees paid to insurance companyUSD $802
Are there contracts with allocated funds for individual policies?No
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $679,438
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $30,044
Amount paid for insurance broker fees802
Additional information about fees paid to insurance brokerINCENTIVES, EDUCATION, COMMUNICATIONS AND TRAINING
Insurance broker organization code?3
Insurance broker nameIMA INC.
ROCKY MOUNTAIN HOSPITAL AND MEDICAL SERVICE, INC. (National Association of Insurance Commissioners NAIC id number: 11011 )
Policy contract number195935
Policy instance 1
Insurance contract or identification number195935
Number of Individuals Covered100
Insurance policy start date2012-07-01
Insurance policy end date2013-06-30
Total amount of commissions paid to insurance brokerUSD $28,784
Total amount of fees paid to insurance companyUSD $560
Are there contracts with allocated funds for individual policies?No
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $671,632
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $28,784
Amount paid for insurance broker fees560
Additional information about fees paid to insurance brokerINCENTIVES, EDUCATION, COMMUNICATION & TRAINING
Insurance broker organization code?3
Insurance broker nameIMA INC.
ROCKY MOUNTAIN HEALTH MAINTENANCE ORGANIZATION INC. (National Association of Insurance Commissioners NAIC id number: 95482 )
Policy contract number11739000
Policy instance 1
Insurance contract or identification number11739000
Number of Individuals Covered91
Insurance policy start date2011-07-01
Insurance policy end date2012-06-30
Total amount of commissions paid to insurance brokerUSD $33,487
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $677,673
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
ROCKY MOUNTAIN HEALTH MAINTENANCE ORGANIZATION INC. (National Association of Insurance Commissioners NAIC id number: 95482 )
Policy contract number11739000
Policy instance 1
Insurance contract or identification number11739000
Number of Individuals Covered105
Insurance policy start date2010-07-01
Insurance policy end date2011-06-30
Total amount of commissions paid to insurance brokerUSD $37,125
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $748,370
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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