401k Plan data: CHARTIERS COMMUNITY MENTAL HEALTH AND RETARDATION GROUP LIFE, AD&D, AND LT DISABILITY plan

CHARTIERS COMMUNITY MENTAL HEALTH AND RETARDATION GROUP LIFE, AD&D, AND LT DISABILITY 401k Plan overview

Plan Name	CHARTIERS COMMUNITY MENTAL HEALTH AND RETARDATION GROUP LIFE, AD&D, AND LT DISABILITY
Plan identification number	501

CHARTIERS COMMUNITY MENTAL HEALTH AND RETARDATION GROUP LIFE, AD&D, AND LT DISABILITY Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Life insurance Dental Long-term disability cover Other welfare benefit cover

401k Sponsoring company profile

CHARTIERS COMMUNITY MENTAL HEALTH AND RETARDATION CENTER, INC. has sponsored the creation of one or more 401k plans.

Company Name: CHARTIERS COMMUNITY MENTAL HEALTH AND RETARDATION CENTER, INC.

Employer identification number (EIN): 251203882

NAIC Classification: 621420
NAIC Description: Outpatient Mental Health and Substance Abuse Centers

Form 5500 Filing Information

Submission information for form 5500 for 401k plan CHARTIERS COMMUNITY MENTAL HEALTH AND RETARDATION GROUP LIFE, AD&D, AND LT DISABILITY

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2013-07-01 KATHERINE RADAKOVICH KATHERINE RADAKOVICH 2014-03-27
501 2012-08-01 KATHERINE RADAKOVICH KATHERINE RADAKOVICH 2014-03-27
501 2011-08-01 SUSAN FLYNN SUSAN FLYNN 2013-04-15
501 2009-07-01 BARBARA KARPAN

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
501	2013-07-01	KATHERINE RADAKOVICH	KATHERINE RADAKOVICH	2014-03-27
501	2012-08-01	KATHERINE RADAKOVICH	KATHERINE RADAKOVICH	2014-03-27
501	2011-08-01	SUSAN FLYNN	SUSAN FLYNN	2013-04-15
501	2009-07-01	BARBARA KARPAN

Plan Statistics for CHARTIERS COMMUNITY MENTAL HEALTH AND RETARDATION GROUP LIFE, AD&D, AND LT DISABILITY

401k plan membership statisitcs for CHARTIERS COMMUNITY MENTAL HEALTH AND RETARDATION GROUP LIFE, AD&D, AND LT DISABILITY

Measure Date Value
2013: CHARTIERS COMMUNITY MENTAL HEALTH AND RETARDATION GROUP LIFE, AD&D, AND LT DISABILITY 2013 401k membership
Total participants, beginning-of-year 2013-07-01 101
Total number of active participants reported on line 7a of the Form 5500 2013-07-01 101
Total of all active and inactive participants 2013-07-01 101
Total participants 2013-07-01 101
2012: CHARTIERS COMMUNITY MENTAL HEALTH AND RETARDATION GROUP LIFE, AD&D, AND LT DISABILITY 2012 401k membership
Total participants, beginning-of-year 2012-08-01 101
Total number of active participants reported on line 7a of the Form 5500 2012-08-01 101
Total of all active and inactive participants 2012-08-01 101
Total participants 2012-08-01 101
2011: CHARTIERS COMMUNITY MENTAL HEALTH AND RETARDATION GROUP LIFE, AD&D, AND LT DISABILITY 2011 401k membership
Total participants, beginning-of-year 2011-08-01 94
Total number of active participants reported on line 7a of the Form 5500 2011-08-01 101
Total of all active and inactive participants 2011-08-01 101
Total participants 2011-08-01 101
2009: CHARTIERS COMMUNITY MENTAL HEALTH AND RETARDATION GROUP LIFE, AD&D, AND LT DISABILITY 2009 401k membership
Total participants, beginning-of-year 2009-07-01 99
Total number of active participants reported on line 7a of the Form 5500 2009-07-01 96
Total of all active and inactive participants 2009-07-01 96

Measure	Date	Value
2013: CHARTIERS COMMUNITY MENTAL HEALTH AND RETARDATION GROUP LIFE, AD&D, AND LT DISABILITY 2013 401k membership
Total participants, beginning-of-year	2013-07-01	101
Total number of active participants reported on line 7a of the Form 5500	2013-07-01	101
Total of all active and inactive participants	2013-07-01	101
Total participants	2013-07-01	101
2012: CHARTIERS COMMUNITY MENTAL HEALTH AND RETARDATION GROUP LIFE, AD&D, AND LT DISABILITY 2012 401k membership
Total participants, beginning-of-year	2012-08-01	101
Total number of active participants reported on line 7a of the Form 5500	2012-08-01	101
Total of all active and inactive participants	2012-08-01	101
Total participants	2012-08-01	101
2011: CHARTIERS COMMUNITY MENTAL HEALTH AND RETARDATION GROUP LIFE, AD&D, AND LT DISABILITY 2011 401k membership
Total participants, beginning-of-year	2011-08-01	94
Total number of active participants reported on line 7a of the Form 5500	2011-08-01	101
Total of all active and inactive participants	2011-08-01	101
Total participants	2011-08-01	101
2009: CHARTIERS COMMUNITY MENTAL HEALTH AND RETARDATION GROUP LIFE, AD&D, AND LT DISABILITY 2009 401k membership
Total participants, beginning-of-year	2009-07-01	99
Total number of active participants reported on line 7a of the Form 5500	2009-07-01	96
Total of all active and inactive participants	2009-07-01	96

Form 5500 Responses for CHARTIERS COMMUNITY MENTAL HEALTH AND RETARDATION GROUP LIFE, AD&D, AND LT DISABILITY

2013: CHARTIERS COMMUNITY MENTAL HEALTH AND RETARDATION GROUP LIFE, AD&D, AND LT DISABILITY 2013 form 5500 responses
2013-07-01	Type of plan entity	Single employer plan
2013-07-01	Submission has been amended	No
2013-07-01	This submission is the final filing	No
2013-07-01	This return/report is a short plan year return/report (less than 12 months)	Yes
2013-07-01	Plan is a collectively bargained plan	No
2013-07-01	Plan funding arrangement – Insurance	Yes
2013-07-01	Plan benefit arrangement – Insurance	Yes
2012: CHARTIERS COMMUNITY MENTAL HEALTH AND RETARDATION GROUP LIFE, AD&D, AND LT DISABILITY 2012 form 5500 responses
2012-08-01	Type of plan entity	Single employer plan
2012-08-01	Submission has been amended	No
2012-08-01	This submission is the final filing	No
2012-08-01	This return/report is a short plan year return/report (less than 12 months)	Yes
2012-08-01	Plan is a collectively bargained plan	No
2012-08-01	Plan funding arrangement – Insurance	Yes
2012-08-01	Plan benefit arrangement – Insurance	Yes
2011: CHARTIERS COMMUNITY MENTAL HEALTH AND RETARDATION GROUP LIFE, AD&D, AND LT DISABILITY 2011 form 5500 responses
2011-08-01	Type of plan entity	Single employer plan
2011-08-01	Submission has been amended	No
2011-08-01	This submission is the final filing	No
2011-08-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-08-01	Plan is a collectively bargained plan	No
2011-08-01	Plan funding arrangement – Insurance	Yes
2011-08-01	Plan benefit arrangement – Insurance	Yes
2009: CHARTIERS COMMUNITY MENTAL HEALTH AND RETARDATION GROUP LIFE, AD&D, AND LT DISABILITY 2009 form 5500 responses
2009-07-01	Type of plan entity	Single employer plan
2009-07-01	This submission is the final filing	No
2009-07-01	Plan funding arrangement – Insurance	Yes
2009-07-01	Plan benefit arrangement – Insurance	Yes

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Company Name:	CHARTIERS COMMUNITY MENTAL HEALTH AND RETARDATION CENTER, INC.
Employer identification number (EIN):	251203882
NAIC Classification:	621420
NAIC Description:	Outpatient Mental Health and Substance Abuse Centers