| Plan Name | COMMUNITY HEALTH PARTNERS EAP PLAN |
| Plan identification number | 504 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
|
| Company Name: | COMMUNITY HEALTH PARTNERS, INC. |
| Employer identification number (EIN): | 841420492 |
| NAIC Classification: | 621112 |
| NAIC Description: | Offices of Physicians, Mental Health Specialists |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 504 | 2022-01-01 | AMBER TRAXINGER | 2023-08-09 | ||
| 504 | 2022-01-01 | AMBER TRAXINGER | 2024-02-15 |
| Measure | Date | Value |
|---|---|---|
| 2022: COMMUNITY HEALTH PARTNERS EAP PLAN 2022 401k membership | ||
| Total participants, beginning-of-year | 2022-01-01 | 135 |
| Total number of active participants reported on line 7a of the Form 5500 | 2022-01-01 | 135 |
| Number of retired or separated participants receiving benefits | 2022-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2022-01-01 | 0 |
| Total of all active and inactive participants | 2022-01-01 | 135 |
| Number of employers contributing to the scheme | 2022-01-01 | 0 |
| 2022: COMMUNITY HEALTH PARTNERS EAP PLAN 2022 form 5500 responses | ||
|---|---|---|
| 2022-01-01 | Type of plan entity | Single employer plan |
| 2022-01-01 | First time form 5500 has been submitted | Yes |
| 2022-01-01 | Submission has been amended | Yes |
| 2022-01-01 | This submission is the final filing | Yes |
| 2022-01-01 | Plan funding arrangement – Insurance | Yes |
| 2022-01-01 | Plan benefit arrangement – Insurance | Yes |
| RELIANT BEHAVIORAL HEALTH (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | 15025491 |
| Policy instance | 1 |