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| Plan Name | PENNSYLVANIA COUNSELING SERVICES HEALTH AND WELFARE PLANS |
| Plan identification number | 502 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | PENNSYLVANIA COUNSELING SERVICES, INC. |
| Employer identification number (EIN): | 251776663 |
| NAIC Classification: | 621330 |
| NAIC Description: | Offices of Mental Health Practitioners (except Physicians) |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 502 | 2020-01-01 |
| 2020: PENNSYLVANIA COUNSELING SERVICES HEALTH AND WELFARE PLANS 2020 form 5500 responses | ||
|---|---|---|
| 2020-01-01 | Type of plan entity | Single employer plan |
| 2020-01-01 | First time form 5500 has been submitted | Yes |
| 2020-01-01 | Submission has been amended | No |
| 2020-01-01 | This submission is the final filing | No |
| 2020-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2020-01-01 | Plan is a collectively bargained plan | No |
| 2020-01-01 | Plan funding arrangement – Insurance | Yes |
| 2020-01-01 | Plan benefit arrangement – Insurance | Yes |
| AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) | |
| Policy contract number | 210000 |
| Policy instance | 1 |
| UNITED CONCORDIA COMPANIES, INC. (National Association of Insurance Commissioners NAIC id number: 89070 ) | |
| Policy contract number | 256291000 |
| Policy instance | 2 |
| VISION BENEFITS OF AMERICA (National Association of Insurance Commissioners NAIC id number: 53953 ) | |
| Policy contract number | 2712 |
| Policy instance | 3 |
| FOUR EVER LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80985 ) | |
| Policy contract number | 8700030 |
| Policy instance | 4 |
| SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) | |
| Policy contract number | 913584 |
| Policy instance | 5 |
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