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COMMUNITY INTEGRATED SERVICES GROUP MEDICAL PLAN 401k Plan overview

Plan NameCOMMUNITY INTEGRATED SERVICES GROUP MEDICAL PLAN
Plan identification number 501

COMMUNITY INTEGRATED SERVICES GROUP MEDICAL PLAN Benefits

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

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

Company Name:COMMUNITY INTEGRATED SERVICES, INC.
Employer identification number (EIN):200006353
NAIC Classification:624100
NAIC Description: Individual and Family Services

Additional information about COMMUNITY INTEGRATED SERVICES, INC.

Jurisdiction of Incorporation: State of Delaware Division of Corporations
Incorporation Date:
Company Identification Number: 3378077

More information about COMMUNITY INTEGRATED SERVICES, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan COMMUNITY INTEGRATED SERVICES GROUP MEDICAL PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012021-08-01CHARLES MORTON2023-02-16
5012020-08-01CHARLES MORTON2022-02-03
5012019-08-01CHARLES MORTON2021-02-23
5012018-08-01CHARLES MORTON2020-02-12
5012017-08-01
5012017-08-01CHARLES MORTON2020-02-12
5012016-08-01CHARLES MORTON CHARLES MORTON2018-02-21
5012014-08-01CHARLES MORTON CHARLES MORTON2016-02-26

Plan Statistics for COMMUNITY INTEGRATED SERVICES GROUP MEDICAL PLAN

401k plan membership statisitcs for COMMUNITY INTEGRATED SERVICES GROUP MEDICAL PLAN

Measure Date Value
2021: COMMUNITY INTEGRATED SERVICES GROUP MEDICAL PLAN 2021 401k membership
Total participants, beginning-of-year2021-08-01127
Total number of active participants reported on line 7a of the Form 55002021-08-01127
Number of retired or separated participants receiving benefits2021-08-010
Number of other retired or separated participants entitled to future benefits2021-08-010
Total of all active and inactive participants2021-08-01127
Number of employers contributing to the scheme2021-08-010
2020: COMMUNITY INTEGRATED SERVICES GROUP MEDICAL PLAN 2020 401k membership
Total participants, beginning-of-year2020-08-01161
Total number of active participants reported on line 7a of the Form 55002020-08-01127
Number of retired or separated participants receiving benefits2020-08-010
Number of other retired or separated participants entitled to future benefits2020-08-010
Total of all active and inactive participants2020-08-01127
Number of employers contributing to the scheme2020-08-010
2019: COMMUNITY INTEGRATED SERVICES GROUP MEDICAL PLAN 2019 401k membership
Total participants, beginning-of-year2019-08-01125
Total number of active participants reported on line 7a of the Form 55002019-08-01161
Number of retired or separated participants receiving benefits2019-08-010
Number of other retired or separated participants entitled to future benefits2019-08-010
Total of all active and inactive participants2019-08-01161
Number of employers contributing to the scheme2019-08-010
2018: COMMUNITY INTEGRATED SERVICES GROUP MEDICAL PLAN 2018 401k membership
Total participants, beginning-of-year2018-08-01113
Total number of active participants reported on line 7a of the Form 55002018-08-01125
Number of retired or separated participants receiving benefits2018-08-010
Number of other retired or separated participants entitled to future benefits2018-08-010
Total of all active and inactive participants2018-08-01125
Number of employers contributing to the scheme2018-08-010
2017: COMMUNITY INTEGRATED SERVICES GROUP MEDICAL PLAN 2017 401k membership
Total participants, beginning-of-year2017-08-01100
Total number of active participants reported on line 7a of the Form 55002017-08-0160
Number of retired or separated participants receiving benefits2017-08-010
Number of other retired or separated participants entitled to future benefits2017-08-010
Total of all active and inactive participants2017-08-0160
Number of employers contributing to the scheme2017-08-010
2016: COMMUNITY INTEGRATED SERVICES GROUP MEDICAL PLAN 2016 401k membership
Total participants, beginning-of-year2016-08-01100
Total number of active participants reported on line 7a of the Form 55002016-08-0195
Number of retired or separated participants receiving benefits2016-08-010
Number of other retired or separated participants entitled to future benefits2016-08-010
Total of all active and inactive participants2016-08-0195
2014: COMMUNITY INTEGRATED SERVICES GROUP MEDICAL PLAN 2014 401k membership
Total participants, beginning-of-year2014-08-01118
Total number of active participants reported on line 7a of the Form 55002014-08-01102
Number of retired or separated participants receiving benefits2014-08-011
Number of other retired or separated participants entitled to future benefits2014-08-010
Total of all active and inactive participants2014-08-01103

Form 5500 Responses for COMMUNITY INTEGRATED SERVICES GROUP MEDICAL PLAN

2021: COMMUNITY INTEGRATED SERVICES GROUP MEDICAL PLAN 2021 form 5500 responses
2021-08-01Type of plan entitySingle employer plan
2021-08-01Plan funding arrangement – InsuranceYes
2021-08-01Plan benefit arrangement – InsuranceYes
2020: COMMUNITY INTEGRATED SERVICES GROUP MEDICAL PLAN 2020 form 5500 responses
2020-08-01Type of plan entitySingle employer plan
2020-08-01Plan funding arrangement – InsuranceYes
2020-08-01Plan benefit arrangement – InsuranceYes
2019: COMMUNITY INTEGRATED SERVICES GROUP MEDICAL PLAN 2019 form 5500 responses
2019-08-01Type of plan entitySingle employer plan
2019-08-01Plan funding arrangement – InsuranceYes
2019-08-01Plan benefit arrangement – InsuranceYes
2018: COMMUNITY INTEGRATED SERVICES GROUP MEDICAL PLAN 2018 form 5500 responses
2018-08-01Type of plan entitySingle employer plan
2018-08-01Plan funding arrangement – InsuranceYes
2018-08-01Plan benefit arrangement – InsuranceYes
2017: COMMUNITY INTEGRATED SERVICES GROUP MEDICAL PLAN 2017 form 5500 responses
2017-08-01Type of plan entitySingle employer plan
2017-08-01Submission has been amendedYes
2017-08-01Plan funding arrangement – InsuranceYes
2017-08-01Plan benefit arrangement – InsuranceYes
2016: COMMUNITY INTEGRATED SERVICES GROUP MEDICAL PLAN 2016 form 5500 responses
2016-08-01Type of plan entitySingle employer plan
2016-08-01Submission has been amendedNo
2016-08-01This submission is the final filingNo
2016-08-01This return/report is a short plan year return/report (less than 12 months)No
2016-08-01Plan is a collectively bargained planNo
2016-08-01Plan funding arrangement – InsuranceYes
2016-08-01Plan benefit arrangement – InsuranceYes
2014: COMMUNITY INTEGRATED SERVICES GROUP MEDICAL PLAN 2014 form 5500 responses
2014-08-01Type of plan entitySingle employer plan
2014-08-01First time form 5500 has been submittedYes
2014-08-01Submission has been amendedNo
2014-08-01This submission is the final filingNo
2014-08-01This return/report is a short plan year return/report (less than 12 months)No
2014-08-01Plan is a collectively bargained planNo
2014-08-01Plan funding arrangement – InsuranceYes
2014-08-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

GROUP HEALTH OPTIONS, INC. (National Association of Insurance Commissioners NAIC id number: 47055 )
Policy contract number6356000
Policy instance 2
Insurance contract or identification number6356000
Number of Individuals Covered18
Insurance policy start date2021-08-01
Insurance policy end date2022-07-31
Total amount of commissions paid to insurance brokerUSD $6,647
Total amount of fees paid to insurance companyUSD $0
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
Welfare Benefit Premiums Paid to CarrierUSD $144,717
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,647
Amount paid for insurance broker fees0
Insurance broker organization code?3
GROUP HEALTH COOPERATIVE (National Association of Insurance Commissioners NAIC id number: 95672 )
Policy contract number1445600
Policy instance 1
Insurance contract or identification number1445600
Number of Individuals Covered143
Insurance policy start date2021-08-01
Insurance policy end date2022-07-31
Total amount of commissions paid to insurance brokerUSD $40,794
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $690,247
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $40,794
Amount paid for insurance broker fees0
Insurance broker organization code?3
GROUP HEALTH OPTIONS, INC. (National Association of Insurance Commissioners NAIC id number: 47055 )
Policy contract number6356000
Policy instance 2
Insurance contract or identification number6356000
Number of Individuals Covered22
Insurance policy start date2020-08-01
Insurance policy end date2021-07-31
Total amount of commissions paid to insurance brokerUSD $6,830
Total amount of fees paid to insurance companyUSD $0
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
Welfare Benefit Premiums Paid to CarrierUSD $139,873
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,830
Amount paid for insurance broker fees0
Insurance broker organization code?3
GROUP HEALTH COOPERATIVE (National Association of Insurance Commissioners NAIC id number: 95672 )
Policy contract number1445600
Policy instance 1
Insurance contract or identification number1445600
Number of Individuals Covered145
Insurance policy start date2020-08-01
Insurance policy end date2021-07-31
Total amount of commissions paid to insurance brokerUSD $26,434
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $670,767
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $26,434
Amount paid for insurance broker fees0
Insurance broker organization code?3
GROUP HEALTH OPTIONS, INC. (National Association of Insurance Commissioners NAIC id number: 47055 )
Policy contract number6356000
Policy instance 2
Insurance contract or identification number6356000
Number of Individuals Covered24
Insurance policy start date2019-08-01
Insurance policy end date2020-07-31
Total amount of commissions paid to insurance brokerUSD $6,722
Total amount of fees paid to insurance companyUSD $0
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
Welfare Benefit Premiums Paid to CarrierUSD $131,325
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,722
Amount paid for insurance broker fees0
Insurance broker organization code?3
GROUP HEALTH COOPERATIVE (National Association of Insurance Commissioners NAIC id number: 95672 )
Policy contract number1445600
Policy instance 1
Insurance contract or identification number1445600
Number of Individuals Covered166
Insurance policy start date2019-08-01
Insurance policy end date2020-07-31
Total amount of commissions paid to insurance brokerUSD $32,171
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $628,951
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $32,171
Amount paid for insurance broker fees0
Insurance broker organization code?3
GROUP HEALTH OPTIONS, INC. (National Association of Insurance Commissioners NAIC id number: 47055 )
Policy contract number6356000
Policy instance 2
Insurance contract or identification number6356000
Number of Individuals Covered14
Insurance policy start date2018-08-01
Insurance policy end date2019-07-31
Total amount of commissions paid to insurance brokerUSD $6,632
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $83,912
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $6,632
Amount paid for insurance broker fees0
Insurance broker organization code?3
GROUP HEALTH COOPERATIVE (National Association of Insurance Commissioners NAIC id number: 95672 )
Policy contract number1445600
Policy instance 1
Insurance contract or identification number1445600
Number of Individuals Covered134
Insurance policy start date2018-08-01
Insurance policy end date2019-07-31
Total amount of commissions paid to insurance brokerUSD $24,247
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $477,244
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $24,247
Amount paid for insurance broker fees0
Insurance broker organization code?3
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number147575
Policy instance 4
Insurance contract or identification number147575
Number of Individuals Covered49
Insurance policy start date2017-08-01
Insurance policy end date2018-07-31
Total amount of commissions paid to insurance brokerUSD $2,761
Total amount of fees paid to insurance companyUSD $293
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
Welfare Benefit Premiums Paid to CarrierUSD $18,550
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 )
Policy contract number5459227
Policy instance 3
Insurance contract or identification number5459227
Number of Individuals Covered79
Insurance policy start date2017-08-01
Insurance policy end date2018-07-31
Total amount of commissions paid to insurance brokerUSD $2,720
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $54,392
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
GROUP HEALTH OPTIONS, INC. (National Association of Insurance Commissioners NAIC id number: 47055 )
Policy contract number6356000
Policy instance 2
Insurance contract or identification number6356000
Number of Individuals Covered23
Insurance policy start date2017-08-01
Insurance policy end date2018-07-31
Total amount of commissions paid to insurance brokerUSD $4,864
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $70,702
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
GROUP HEALTH COOPERATIVE (National Association of Insurance Commissioners NAIC id number: 95672 )
Policy contract number1445600
Policy instance 1
Insurance contract or identification number1445600
Number of Individuals Covered117
Insurance policy start date2017-08-01
Insurance policy end date2018-07-31
Total amount of commissions paid to insurance brokerUSD $23,488
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $435,444
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes

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