401k Plan data: TRI-COUNTY MENTAL HEALTH & COUNSELING EMPLOYEE HEALTH PLAN plan

TRI-COUNTY MENTAL HEALTH & COUNSELING EMPLOYEE HEALTH PLAN 401k Plan overview

Plan Name	TRI-COUNTY MENTAL HEALTH & COUNSELING EMPLOYEE HEALTH PLAN
Plan identification number	501

TRI-COUNTY MENTAL HEALTH & COUNSELING EMPLOYEE HEALTH PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) Life insurance Dental Vision Temporary disability (accident and sickness) Long-term disability cover

401k Sponsoring company profile

TRI-COUNTY MENTAL HEALTH & COUNSELING SERVICES, INC. has sponsored the creation of one or more 401k plans.

Company Name: TRI-COUNTY MENTAL HEALTH & COUNSELING SERVICES, INC.

Employer identification number (EIN): 310860366

NAIC Classification: 621112
NAIC Description: Offices of Physicians, Mental Health Specialists

Form 5500 Filing Information

Submission information for form 5500 for 401k plan TRI-COUNTY MENTAL HEALTH & COUNSELING EMPLOYEE HEALTH PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2013-01-01 AMANDA PUTNAM
501 2012-01-01 GEORGE P. WEIGLY GEORGE P. WEIGLY 2013-07-30
501 2011-01-01 GEORGE P. WEIGLY
501 2009-03-01 GEORGE P. WEIGLY
501 2009-03-01 GEORGE P. WEIGLY
501 2009-03-01 GEORGE P. WEIGLY

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
501	2013-01-01	AMANDA PUTNAM
501	2012-01-01	GEORGE P. WEIGLY	GEORGE P. WEIGLY	2013-07-30
501	2011-01-01	GEORGE P. WEIGLY
501	2009-03-01	GEORGE P. WEIGLY
501	2009-03-01	GEORGE P. WEIGLY
501	2009-03-01	GEORGE P. WEIGLY

Plan Statistics for TRI-COUNTY MENTAL HEALTH & COUNSELING EMPLOYEE HEALTH PLAN

401k plan membership statisitcs for TRI-COUNTY MENTAL HEALTH & COUNSELING EMPLOYEE HEALTH PLAN

Measure Date Value
2013: TRI-COUNTY MENTAL HEALTH & COUNSELING EMPLOYEE HEALTH PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 149
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 0
Total of all active and inactive participants 2013-01-01 0
2012: TRI-COUNTY MENTAL HEALTH & COUNSELING EMPLOYEE HEALTH PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 140
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 143
Number of retired or separated participants receiving benefits 2012-01-01 0
Number of other retired or separated participants entitled to future benefits 2012-01-01 0
Total of all active and inactive participants 2012-01-01 143
2011: TRI-COUNTY MENTAL HEALTH & COUNSELING EMPLOYEE HEALTH PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 134
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 143
Number of retired or separated participants receiving benefits 2011-01-01 0
Number of other retired or separated participants entitled to future benefits 2011-01-01 0
Total of all active and inactive participants 2011-01-01 143
2009: TRI-COUNTY MENTAL HEALTH & COUNSELING EMPLOYEE HEALTH PLAN 2009 401k membership
Total participants, beginning-of-year 2009-03-01 117
Total number of active participants reported on line 7a of the Form 5500 2009-03-01 129
Number of retired or separated participants receiving benefits 2009-03-01 0
Number of other retired or separated participants entitled to future benefits 2009-03-01 0
Total of all active and inactive participants 2009-03-01 129

Measure	Date	Value
2013: TRI-COUNTY MENTAL HEALTH & COUNSELING EMPLOYEE HEALTH PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	149
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	0
Total of all active and inactive participants	2013-01-01	0
2012: TRI-COUNTY MENTAL HEALTH & COUNSELING EMPLOYEE HEALTH PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	140
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	143
Number of retired or separated participants receiving benefits	2012-01-01	0
Number of other retired or separated participants entitled to future benefits	2012-01-01	0
Total of all active and inactive participants	2012-01-01	143
2011: TRI-COUNTY MENTAL HEALTH & COUNSELING EMPLOYEE HEALTH PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	134
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	143
Number of retired or separated participants receiving benefits	2011-01-01	0
Number of other retired or separated participants entitled to future benefits	2011-01-01	0
Total of all active and inactive participants	2011-01-01	143
2009: TRI-COUNTY MENTAL HEALTH & COUNSELING EMPLOYEE HEALTH PLAN 2009 401k membership
Total participants, beginning-of-year	2009-03-01	117
Total number of active participants reported on line 7a of the Form 5500	2009-03-01	129
Number of retired or separated participants receiving benefits	2009-03-01	0
Number of other retired or separated participants entitled to future benefits	2009-03-01	0
Total of all active and inactive participants	2009-03-01	129

Financial Data on TRI-COUNTY MENTAL HEALTH & COUNSELING EMPLOYEE HEALTH PLAN

Measure	Date	Value
2013 : TRI-COUNTY MENTAL HEALTH & COUNSELING EMPLOYEE HEALTH PLAN 2013 401k financial data
Total unrealized appreciation/depreciation of assets	2013-12-31	$0
Total transfer of assets from this plan	2013-12-31	$71,069
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-12-31	$350,564
Total income from all sources (including contributions)	2013-12-31	$1,359,088
Total loss/gain on sale of assets	2013-12-31	$0
Total of all expenses incurred	2013-12-31	$1,473,905
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2013-12-31	$1,408,113
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2013-12-31	$1,358,856
Value of total assets at end of year	2013-12-31	$0
Value of total assets at beginning of year	2013-12-31	$536,450
Total of administrative expenses incurred including professional, contract, advisory and management fees	2013-12-31	$65,792
Total interest from all sources	2013-12-31	$232
Total dividends received (eg from common stock, registered investment company shares)	2013-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2013-12-31	Yes
Administrative expenses professional fees incurred	2013-12-31	$500
Was this plan covered by a fidelity bond	2013-12-31	Yes
Value of fidelity bond cover	2013-12-31	$500,000
Were there any nonexempt tranactions with any party-in-interest	2013-12-31	No
Contributions received from participants	2013-12-31	$170,364
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2013-12-31	$0
Administrative expenses (other) incurred	2013-12-31	$266
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2013-12-31	No
Value of net income/loss	2013-12-31	$-114,817
Value of net assets at end of year (total assets less liabilities)	2013-12-31	$0
Value of net assets at beginning of year (total assets less liabilities)	2013-12-31	$185,886
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2013-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2013-12-31	No
Were any leases to which the plan was party in default or uncollectible	2013-12-31	No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2013-12-31	$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2013-12-31	$230,824
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2013-12-31	$230,824
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2013-12-31	$232
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2013-12-31	$0
Expenses. Payments to insurance carriers foe the provision of benefits	2013-12-31	$281,651
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2013-12-31	No
Was there a failure to transmit to the plan any participant contributions	2013-12-31	No
Has the plan failed to provide any benefit when due under the plan	2013-12-31	No
Contributions received in cash from employer	2013-12-31	$1,188,492
Employer contributions (assets) at end of year	2013-12-31	$0
Employer contributions (assets) at beginning of year	2013-12-31	$305,626
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2013-12-31	$1,126,462
Contract administrator fees	2013-12-31	$65,026
Liabilities. Value of benefit claims payable at end of year	2013-12-31	$0
Liabilities. Value of benefit claims payable at beginning of year	2013-12-31	$350,564
Did the plan have assets held for investment	2013-12-31	No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2013-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2013-12-31	Yes
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2013-12-31	No
Opinion of an independent qualified public accountant for this plan	2013-12-31	Unqualified
Accountancy firm name	2013-12-31	ROMINE CPA'S & ASSOCIATES
Accountancy firm EIN	2013-12-31	263841391
2012 : TRI-COUNTY MENTAL HEALTH & COUNSELING EMPLOYEE HEALTH PLAN 2012 401k financial data
Total unrealized appreciation/depreciation of assets	2012-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-12-31	$350,564
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-12-31	$173,497
Total income from all sources (including contributions)	2012-12-31	$1,830,767
Total loss/gain on sale of assets	2012-12-31	$0
Total of all expenses incurred	2012-12-31	$1,861,811
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-12-31	$1,767,129
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-12-31	$1,830,342
Value of total assets at end of year	2012-12-31	$536,450
Value of total assets at beginning of year	2012-12-31	$390,427
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-12-31	$94,682
Total interest from all sources	2012-12-31	$425
Total dividends received (eg from common stock, registered investment company shares)	2012-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2012-12-31	No
Administrative expenses professional fees incurred	2012-12-31	$2,900
Was this plan covered by a fidelity bond	2012-12-31	Yes
Value of fidelity bond cover	2012-12-31	$500,000
Were there any nonexempt tranactions with any party-in-interest	2012-12-31	No
Contributions received from participants	2012-12-31	$438,259
Administrative expenses (other) incurred	2012-12-31	$501
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-12-31	No
Value of net income/loss	2012-12-31	$-31,044
Value of net assets at end of year (total assets less liabilities)	2012-12-31	$185,886
Value of net assets at beginning of year (total assets less liabilities)	2012-12-31	$216,930
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2012-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2012-12-31	No
Were any leases to which the plan was party in default or uncollectible	2012-12-31	No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2012-12-31	$230,824
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2012-12-31	$261,571
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2012-12-31	$261,571
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2012-12-31	$425
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2012-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2012-12-31	$0
Expenses. Payments to insurance carriers foe the provision of benefits	2012-12-31	$403,473
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2012-12-31	No
Was there a failure to transmit to the plan any participant contributions	2012-12-31	No
Has the plan failed to provide any benefit when due under the plan	2012-12-31	No
Contributions received in cash from employer	2012-12-31	$1,392,083
Employer contributions (assets) at end of year	2012-12-31	$305,626
Employer contributions (assets) at beginning of year	2012-12-31	$128,856
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2012-12-31	$1,363,656
Contract administrator fees	2012-12-31	$91,281
Liabilities. Value of benefit claims payable at end of year	2012-12-31	$350,564
Liabilities. Value of benefit claims payable at beginning of year	2012-12-31	$173,497
Did the plan have assets held for investment	2012-12-31	No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2012-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2012-12-31	No
Opinion of an independent qualified public accountant for this plan	2012-12-31	Unqualified
Accountancy firm name	2012-12-31	POLING CPA GROUP
Accountancy firm EIN	2012-12-31	263841391
2011 : TRI-COUNTY MENTAL HEALTH & COUNSELING EMPLOYEE HEALTH PLAN 2011 401k financial data
Total unrealized appreciation/depreciation of assets	2011-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-12-31	$173,497
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-12-31	$244,424
Total income from all sources (including contributions)	2011-12-31	$1,509,427
Total loss/gain on sale of assets	2011-12-31	$0
Total of all expenses incurred	2011-12-31	$1,357,826
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-12-31	$1,265,674
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-12-31	$1,508,826
Value of total assets at end of year	2011-12-31	$390,427
Value of total assets at beginning of year	2011-12-31	$309,753
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-12-31	$92,152
Total interest from all sources	2011-12-31	$601
Total dividends received (eg from common stock, registered investment company shares)	2011-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2011-12-31	No
Administrative expenses professional fees incurred	2011-12-31	$3,400
Was this plan covered by a fidelity bond	2011-12-31	Yes
Value of fidelity bond cover	2011-12-31	$500,000
Were there any nonexempt tranactions with any party-in-interest	2011-12-31	No
Contributions received from participants	2011-12-31	$297,368
Administrative expenses (other) incurred	2011-12-31	$189
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-12-31	No
Value of net income/loss	2011-12-31	$151,601
Value of net assets at end of year (total assets less liabilities)	2011-12-31	$216,930
Value of net assets at beginning of year (total assets less liabilities)	2011-12-31	$65,329
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2011-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2011-12-31	No
Were any leases to which the plan was party in default or uncollectible	2011-12-31	No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2011-12-31	$261,571
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2011-12-31	$103,027
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2011-12-31	$103,027
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2011-12-31	$601
Expenses. Payments to insurance carriers foe the provision of benefits	2011-12-31	$343,350
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2011-12-31	No
Was there a failure to transmit to the plan any participant contributions	2011-12-31	No
Has the plan failed to provide any benefit when due under the plan	2011-12-31	No
Contributions received in cash from employer	2011-12-31	$1,211,458
Employer contributions (assets) at end of year	2011-12-31	$128,856
Employer contributions (assets) at beginning of year	2011-12-31	$206,726
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2011-12-31	$922,324
Contract administrator fees	2011-12-31	$88,563
Liabilities. Value of benefit claims payable at end of year	2011-12-31	$173,497
Liabilities. Value of benefit claims payable at beginning of year	2011-12-31	$244,424
Did the plan have assets held for investment	2011-12-31	No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2011-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2011-12-31	No
Opinion of an independent qualified public accountant for this plan	2011-12-31	Unqualified
Accountancy firm name	2011-12-31	THE POLING CPA GROUP
Accountancy firm EIN	2011-12-31	263841391
2010 : TRI-COUNTY MENTAL HEALTH & COUNSELING EMPLOYEE HEALTH PLAN 2010 401k financial data
Total unrealized appreciation/depreciation of assets	2010-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2010-12-31	$244,424
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2010-12-31	$69,138
Total income from all sources (including contributions)	2010-12-31	$1,427,714
Total loss/gain on sale of assets	2010-12-31	$0
Total of all expenses incurred	2010-12-31	$1,509,897
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2010-12-31	$1,431,695
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2010-12-31	$1,427,364
Value of total assets at end of year	2010-12-31	$309,753
Value of total assets at beginning of year	2010-12-31	$216,650
Total of administrative expenses incurred including professional, contract, advisory and management fees	2010-12-31	$78,202
Total interest from all sources	2010-12-31	$350
Total dividends received (eg from common stock, registered investment company shares)	2010-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2010-12-31	No
Administrative expenses professional fees incurred	2010-12-31	$3,400
Was this plan covered by a fidelity bond	2010-12-31	Yes
Value of fidelity bond cover	2010-12-31	$500,000
Were there any nonexempt tranactions with any party-in-interest	2010-12-31	No
Contributions received from participants	2010-12-31	$263,633
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2010-12-31	No
Value of net income/loss	2010-12-31	$-82,183
Value of net assets at end of year (total assets less liabilities)	2010-12-31	$65,329
Value of net assets at beginning of year (total assets less liabilities)	2010-12-31	$147,512
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2010-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2010-12-31	No
Were any leases to which the plan was party in default or uncollectible	2010-12-31	No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2010-12-31	$103,027
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2010-12-31	$184,114
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2010-12-31	$184,114
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2010-12-31	$350
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2010-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2010-12-31	$0
Expenses. Payments to insurance carriers foe the provision of benefits	2010-12-31	$265,968
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2010-12-31	No
Was there a failure to transmit to the plan any participant contributions	2010-12-31	No
Has the plan failed to provide any benefit when due under the plan	2010-12-31	No
Contributions received in cash from employer	2010-12-31	$1,163,731
Employer contributions (assets) at end of year	2010-12-31	$206,726
Employer contributions (assets) at beginning of year	2010-12-31	$32,536
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2010-12-31	$1,165,727
Contract administrator fees	2010-12-31	$74,802
Liabilities. Value of benefit claims payable at end of year	2010-12-31	$244,424
Liabilities. Value of benefit claims payable at beginning of year	2010-12-31	$69,138
Did the plan have assets held for investment	2010-12-31	No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2010-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2010-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2010-12-31	No
Opinion of an independent qualified public accountant for this plan	2010-12-31	Unqualified
Accountancy firm name	2010-12-31	THE POLING CPA GROUP
Accountancy firm EIN	2010-12-31	263841391

Form 5500 Responses for TRI-COUNTY MENTAL HEALTH & COUNSELING EMPLOYEE HEALTH PLAN

2013: TRI-COUNTY MENTAL HEALTH & COUNSELING EMPLOYEE HEALTH PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Submission has been amended	No
2013-01-01	This submission is the final filing	Yes
2013-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-01-01	Plan is a collectively bargained plan	No
2013-01-01	Plan funding arrangement – Insurance	Yes
2013-01-01	Plan funding arrangement – Trust	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2013-01-01	Plan benefit arrangement - Trust	Yes
2012: TRI-COUNTY MENTAL HEALTH & COUNSELING EMPLOYEE HEALTH PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Submission has been amended	No
2012-01-01	This submission is the final filing	No
2012-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-01-01	Plan is a collectively bargained plan	No
2012-01-01	Plan funding arrangement – Insurance	Yes
2012-01-01	Plan funding arrangement – Trust	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement - Trust	Yes
2011: TRI-COUNTY MENTAL HEALTH & COUNSELING EMPLOYEE HEALTH PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Submission has been amended	No
2011-01-01	This submission is the final filing	No
2011-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-01-01	Plan is a collectively bargained plan	No
2011-01-01	Plan funding arrangement – Insurance	Yes
2011-01-01	Plan funding arrangement – Trust	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2011-01-01	Plan benefit arrangement - Trust	Yes
2009: TRI-COUNTY MENTAL HEALTH & COUNSELING EMPLOYEE HEALTH PLAN 2009 form 5500 responses
2009-03-01	Type of plan entity	Single employer plan
2009-03-01	Submission has been amended	No
2009-03-01	This submission is the final filing	No
2009-03-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-03-01	Plan is a collectively bargained plan	No
2009-03-01	Plan funding arrangement – Insurance	Yes
2009-03-01	Plan funding arrangement – Trust	Yes
2009-03-01	Plan benefit arrangement – Insurance	Yes
2009-03-01	Plan benefit arrangement - Trust	Yes

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Company Name:	TRI-COUNTY MENTAL HEALTH & COUNSELING SERVICES, INC.
Employer identification number (EIN):	310860366
NAIC Classification:	621112
NAIC Description:	Offices of Physicians, Mental Health Specialists