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OTIS R. BOWEN CENTER FOR HUMAN SERVICES, INC. CONSOLIDATED WELFARE BENEFIT PLAN 401k Plan overview

Plan NameOTIS R. BOWEN CENTER FOR HUMAN SERVICES, INC. CONSOLIDATED WELFARE BENEFIT PLAN
Plan identification number 511

OTIS R. BOWEN CENTER FOR HUMAN SERVICES, INC. CONSOLIDATED WELFARE BENEFIT PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Vision
  • Long-term disability cover
  • Death benefits (include travel accident but not life insurance)
  • Other welfare benefit cover

401k Sponsoring company profile

OTIS R. BOWEN CENTER FOR HUMAN SERVICES, INC. has sponsored the creation of one or more 401k plans.

Company Name:OTIS R. BOWEN CENTER FOR HUMAN SERVICES, INC.
Employer identification number (EIN):351057889
NAIC Classification:621330
NAIC Description:Offices of Mental Health Practitioners (except Physicians)

Form 5500 Filing Information

Submission information for form 5500 for 401k plan OTIS R. BOWEN CENTER FOR HUMAN SERVICES, INC. CONSOLIDATED WELFARE BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5112021-10-01JAY BAUMGARTNER2023-03-29
5112020-10-01JAY BAUMGARTNER2022-07-06
5112019-10-01JAY BAUMGARTNER2021-04-27
5112018-10-01
5112017-10-01
5112016-10-01JAY BAUMGARTNER JAY BAUMGARTNER2018-04-24
5112015-10-01JAY BAUMGARTNER JAY BAUMGARTNER2017-04-27
5112014-10-01JAY BAUMGARTNER JAY BAUMGARTNER2016-04-25
5112013-10-01JAY M. BAUMGARTNER JAY M. BAUMGARTNER2015-04-23
5112012-10-01JAY M. BAUMGARTNER JAY M. BAUMGARTNER2014-04-29
5112011-10-01JAY BAUMGARTNER JAY BAUMGARTNER2013-06-10
5112009-10-01JAY BAUMGARTNER JAY BAUMGARTNER2011-04-21

Plan Statistics for OTIS R. BOWEN CENTER FOR HUMAN SERVICES, INC. CONSOLIDATED WELFARE BENEFIT PLAN

401k plan membership statisitcs for OTIS R. BOWEN CENTER FOR HUMAN SERVICES, INC. CONSOLIDATED WELFARE BENEFIT PLAN

Measure Date Value
2021: OTIS R. BOWEN CENTER FOR HUMAN SERVICES, INC. CONSOLIDATED WELFARE BENEFIT PLAN 2021 401k membership
Total participants, beginning-of-year2021-10-011,355
Total number of active participants reported on line 7a of the Form 55002021-10-011,243
Number of retired or separated participants receiving benefits2021-10-010
Number of other retired or separated participants entitled to future benefits2021-10-010
Total of all active and inactive participants2021-10-011,243
Number of employers contributing to the scheme2021-10-010
2020: OTIS R. BOWEN CENTER FOR HUMAN SERVICES, INC. CONSOLIDATED WELFARE BENEFIT PLAN 2020 401k membership
Total participants, beginning-of-year2020-10-011,123
Total number of active participants reported on line 7a of the Form 55002020-10-011,355
Number of retired or separated participants receiving benefits2020-10-016
Number of other retired or separated participants entitled to future benefits2020-10-010
Total of all active and inactive participants2020-10-011,361
Number of employers contributing to the scheme2020-10-010
2019: OTIS R. BOWEN CENTER FOR HUMAN SERVICES, INC. CONSOLIDATED WELFARE BENEFIT PLAN 2019 401k membership
Total participants, beginning-of-year2019-10-011,132
Total number of active participants reported on line 7a of the Form 55002019-10-011,123
Number of retired or separated participants receiving benefits2019-10-012
Number of other retired or separated participants entitled to future benefits2019-10-010
Total of all active and inactive participants2019-10-011,125
Number of employers contributing to the scheme2019-10-010
2018: OTIS R. BOWEN CENTER FOR HUMAN SERVICES, INC. CONSOLIDATED WELFARE BENEFIT PLAN 2018 401k membership
Total participants, beginning-of-year2018-10-01959
Total number of active participants reported on line 7a of the Form 55002018-10-011,126
Number of retired or separated participants receiving benefits2018-10-016
Number of other retired or separated participants entitled to future benefits2018-10-010
Total of all active and inactive participants2018-10-011,132
2017: OTIS R. BOWEN CENTER FOR HUMAN SERVICES, INC. CONSOLIDATED WELFARE BENEFIT PLAN 2017 401k membership
Total participants, beginning-of-year2017-10-01911
Total number of active participants reported on line 7a of the Form 55002017-10-01959
Number of retired or separated participants receiving benefits2017-10-010
Number of other retired or separated participants entitled to future benefits2017-10-010
Total of all active and inactive participants2017-10-01959
2016: OTIS R. BOWEN CENTER FOR HUMAN SERVICES, INC. CONSOLIDATED WELFARE BENEFIT PLAN 2016 401k membership
Total participants, beginning-of-year2016-10-01906
Total number of active participants reported on line 7a of the Form 55002016-10-01911
Number of retired or separated participants receiving benefits2016-10-010
Number of other retired or separated participants entitled to future benefits2016-10-010
Total of all active and inactive participants2016-10-01911
2015: OTIS R. BOWEN CENTER FOR HUMAN SERVICES, INC. CONSOLIDATED WELFARE BENEFIT PLAN 2015 401k membership
Total participants, beginning-of-year2015-10-01789
Total number of active participants reported on line 7a of the Form 55002015-10-01904
Number of retired or separated participants receiving benefits2015-10-012
Number of other retired or separated participants entitled to future benefits2015-10-010
Total of all active and inactive participants2015-10-01906
2014: OTIS R. BOWEN CENTER FOR HUMAN SERVICES, INC. CONSOLIDATED WELFARE BENEFIT PLAN 2014 401k membership
Total participants, beginning-of-year2014-10-01680
Total number of active participants reported on line 7a of the Form 55002014-10-01787
Number of retired or separated participants receiving benefits2014-10-014
Number of other retired or separated participants entitled to future benefits2014-10-010
Total of all active and inactive participants2014-10-01791
2013: OTIS R. BOWEN CENTER FOR HUMAN SERVICES, INC. CONSOLIDATED WELFARE BENEFIT PLAN 2013 401k membership
Total participants, beginning-of-year2013-10-01620
Total number of active participants reported on line 7a of the Form 55002013-10-01670
Number of retired or separated participants receiving benefits2013-10-016
Number of other retired or separated participants entitled to future benefits2013-10-010
Total of all active and inactive participants2013-10-01676
2012: OTIS R. BOWEN CENTER FOR HUMAN SERVICES, INC. CONSOLIDATED WELFARE BENEFIT PLAN 2012 401k membership
Total participants, beginning-of-year2012-10-01537
Total number of active participants reported on line 7a of the Form 55002012-10-01607
Number of retired or separated participants receiving benefits2012-10-0113
Number of other retired or separated participants entitled to future benefits2012-10-010
Total of all active and inactive participants2012-10-01620
2011: OTIS R. BOWEN CENTER FOR HUMAN SERVICES, INC. CONSOLIDATED WELFARE BENEFIT PLAN 2011 401k membership
Total participants, beginning-of-year2011-10-01436
Total number of active participants reported on line 7a of the Form 55002011-10-01456
Number of retired or separated participants receiving benefits2011-10-012
Number of other retired or separated participants entitled to future benefits2011-10-010
Total of all active and inactive participants2011-10-01458
2009: OTIS R. BOWEN CENTER FOR HUMAN SERVICES, INC. CONSOLIDATED WELFARE BENEFIT PLAN 2009 401k membership
Total participants, beginning-of-year2009-10-01408
Total number of active participants reported on line 7a of the Form 55002009-10-01432
Number of retired or separated participants receiving benefits2009-10-010
Number of other retired or separated participants entitled to future benefits2009-10-010
Total of all active and inactive participants2009-10-01432

Form 5500 Responses for OTIS R. BOWEN CENTER FOR HUMAN SERVICES, INC. CONSOLIDATED WELFARE BENEFIT PLAN

2021: OTIS R. BOWEN CENTER FOR HUMAN SERVICES, INC. CONSOLIDATED WELFARE BENEFIT PLAN 2021 form 5500 responses
2021-10-01Type of plan entitySingle employer plan
2021-10-01Plan funding arrangement – InsuranceYes
2021-10-01Plan funding arrangement – General assets of the sponsorYes
2021-10-01Plan benefit arrangement – InsuranceYes
2021-10-01Plan benefit arrangement – General assets of the sponsorYes
2020: OTIS R. BOWEN CENTER FOR HUMAN SERVICES, INC. CONSOLIDATED WELFARE BENEFIT PLAN 2020 form 5500 responses
2020-10-01Type of plan entitySingle employer plan
2020-10-01Plan funding arrangement – InsuranceYes
2020-10-01Plan funding arrangement – General assets of the sponsorYes
2020-10-01Plan benefit arrangement – InsuranceYes
2020-10-01Plan benefit arrangement – General assets of the sponsorYes
2019: OTIS R. BOWEN CENTER FOR HUMAN SERVICES, INC. CONSOLIDATED WELFARE BENEFIT PLAN 2019 form 5500 responses
2019-10-01Type of plan entitySingle employer plan
2019-10-01Plan funding arrangement – InsuranceYes
2019-10-01Plan funding arrangement – General assets of the sponsorYes
2019-10-01Plan benefit arrangement – InsuranceYes
2019-10-01Plan benefit arrangement – General assets of the sponsorYes
2018: OTIS R. BOWEN CENTER FOR HUMAN SERVICES, INC. CONSOLIDATED WELFARE BENEFIT PLAN 2018 form 5500 responses
2018-10-01Type of plan entitySingle employer plan
2018-10-01Submission has been amendedNo
2018-10-01This submission is the final filingNo
2018-10-01This return/report is a short plan year return/report (less than 12 months)No
2018-10-01Plan is a collectively bargained planNo
2018-10-01Plan funding arrangement – InsuranceYes
2018-10-01Plan funding arrangement – General assets of the sponsorYes
2018-10-01Plan benefit arrangement – InsuranceYes
2018-10-01Plan benefit arrangement – General assets of the sponsorYes
2017: OTIS R. BOWEN CENTER FOR HUMAN SERVICES, INC. CONSOLIDATED WELFARE BENEFIT PLAN 2017 form 5500 responses
2017-10-01Type of plan entitySingle employer plan
2017-10-01Submission has been amendedNo
2017-10-01This submission is the final filingNo
2017-10-01This return/report is a short plan year return/report (less than 12 months)No
2017-10-01Plan is a collectively bargained planNo
2017-10-01Plan funding arrangement – InsuranceYes
2017-10-01Plan funding arrangement – General assets of the sponsorYes
2017-10-01Plan benefit arrangement – InsuranceYes
2017-10-01Plan benefit arrangement – General assets of the sponsorYes
2016: OTIS R. BOWEN CENTER FOR HUMAN SERVICES, INC. CONSOLIDATED WELFARE BENEFIT PLAN 2016 form 5500 responses
2016-10-01Type of plan entitySingle employer plan
2016-10-01Submission has been amendedNo
2016-10-01This submission is the final filingNo
2016-10-01This return/report is a short plan year return/report (less than 12 months)No
2016-10-01Plan is a collectively bargained planNo
2016-10-01Plan funding arrangement – InsuranceYes
2016-10-01Plan funding arrangement – General assets of the sponsorYes
2016-10-01Plan benefit arrangement – InsuranceYes
2016-10-01Plan benefit arrangement – General assets of the sponsorYes
2015: OTIS R. BOWEN CENTER FOR HUMAN SERVICES, INC. CONSOLIDATED WELFARE BENEFIT PLAN 2015 form 5500 responses
2015-10-01Type of plan entitySingle employer plan
2015-10-01Submission has been amendedNo
2015-10-01This submission is the final filingNo
2015-10-01This return/report is a short plan year return/report (less than 12 months)No
2015-10-01Plan is a collectively bargained planNo
2015-10-01Plan funding arrangement – InsuranceYes
2015-10-01Plan funding arrangement – General assets of the sponsorYes
2015-10-01Plan benefit arrangement – InsuranceYes
2015-10-01Plan benefit arrangement – General assets of the sponsorYes
2014: OTIS R. BOWEN CENTER FOR HUMAN SERVICES, INC. CONSOLIDATED WELFARE BENEFIT PLAN 2014 form 5500 responses
2014-10-01Type of plan entitySingle employer plan
2014-10-01Submission has been amendedNo
2014-10-01This submission is the final filingNo
2014-10-01This return/report is a short plan year return/report (less than 12 months)No
2014-10-01Plan is a collectively bargained planNo
2014-10-01Plan funding arrangement – InsuranceYes
2014-10-01Plan funding arrangement – General assets of the sponsorYes
2014-10-01Plan benefit arrangement – InsuranceYes
2014-10-01Plan benefit arrangement – General assets of the sponsorYes
2013: OTIS R. BOWEN CENTER FOR HUMAN SERVICES, INC. CONSOLIDATED WELFARE BENEFIT PLAN 2013 form 5500 responses
2013-10-01Type of plan entitySingle employer plan
2013-10-01Submission has been amendedNo
2013-10-01This submission is the final filingNo
2013-10-01This return/report is a short plan year return/report (less than 12 months)No
2013-10-01Plan is a collectively bargained planNo
2013-10-01Plan funding arrangement – InsuranceYes
2013-10-01Plan funding arrangement – General assets of the sponsorYes
2013-10-01Plan benefit arrangement – InsuranceYes
2013-10-01Plan benefit arrangement – General assets of the sponsorYes
2012: OTIS R. BOWEN CENTER FOR HUMAN SERVICES, INC. CONSOLIDATED WELFARE BENEFIT PLAN 2012 form 5500 responses
2012-10-01Type of plan entitySingle employer plan
2012-10-01Submission has been amendedNo
2012-10-01This submission is the final filingNo
2012-10-01This return/report is a short plan year return/report (less than 12 months)No
2012-10-01Plan is a collectively bargained planNo
2012-10-01Plan funding arrangement – InsuranceYes
2012-10-01Plan funding arrangement – General assets of the sponsorYes
2012-10-01Plan benefit arrangement – InsuranceYes
2012-10-01Plan benefit arrangement – General assets of the sponsorYes
2011: OTIS R. BOWEN CENTER FOR HUMAN SERVICES, INC. CONSOLIDATED WELFARE BENEFIT PLAN 2011 form 5500 responses
2011-10-01Type of plan entitySingle employer plan
2011-10-01Submission has been amendedNo
2011-10-01This submission is the final filingNo
2011-10-01This return/report is a short plan year return/report (less than 12 months)No
2011-10-01Plan is a collectively bargained planNo
2011-10-01Plan funding arrangement – InsuranceYes
2011-10-01Plan funding arrangement – General assets of the sponsorYes
2011-10-01Plan benefit arrangement – InsuranceYes
2011-10-01Plan benefit arrangement – General assets of the sponsorYes
2009: OTIS R. BOWEN CENTER FOR HUMAN SERVICES, INC. CONSOLIDATED WELFARE BENEFIT PLAN 2009 form 5500 responses
2009-10-01Type of plan entitySingle employer plan
2009-10-01Submission has been amendedNo
2009-10-01This submission is the final filingNo
2009-10-01This return/report is a short plan year return/report (less than 12 months)No
2009-10-01Plan is a collectively bargained planNo
2009-10-01Plan funding arrangement – InsuranceYes
2009-10-01Plan funding arrangement – General assets of the sponsorYes
2009-10-01Plan benefit arrangement – InsuranceYes
2009-10-01Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

SYMETRA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68608 )
Policy contract number01-018104-00
Policy instance 1
Insurance contract or identification number01-018104-00
Number of Individuals Covered1243
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $23,767
Total amount of fees paid to insurance companyUSD $4,166
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $226,125
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $23,767
Amount paid for insurance broker fees4166
Additional information about fees paid to insurance brokerGROUP VOLUME BONUS
Insurance broker organization code?3
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number30011071
Policy instance 2
Insurance contract or identification number30011071
Number of Individuals Covered714
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $107,964
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SYMETRA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68608 )
Policy contract number01-018104-00
Policy instance 1
Insurance contract or identification number01-018104-00
Number of Individuals Covered1355
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $20,172
Total amount of fees paid to insurance companyUSD $3,660
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $179,633
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $20,172
Amount paid for insurance broker fees3660
Additional information about fees paid to insurance brokerGROUP VOLUME BONUS
Insurance broker organization code?3
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number30011071
Policy instance 2
Insurance contract or identification number30011071
Number of Individuals Covered749
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $106,675
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
ANTHEM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61069 )
Policy contract numberAL00006227
Policy instance 1
Insurance contract or identification numberAL00006227
Number of Individuals Covered1123
Insurance policy start date2019-10-01
Insurance policy end date2020-09-30
Total amount of commissions paid to insurance brokerUSD $12,262
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $60,638
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $12,262
Amount paid for insurance broker fees0
Insurance broker organization code?3
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number30011071
Policy instance 2
Insurance contract or identification number30011071
Number of Individuals Covered659
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
ANTHEM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61069 )
Policy contract numberAL00006227
Policy instance 1
Insurance contract or identification numberAL00006227
Number of Individuals Covered1126
Insurance policy start date2018-10-01
Insurance policy end date2019-09-30
Total amount of commissions paid to insurance brokerUSD $22,358
Total amount of fees paid to insurance companyUSD $7,239
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $174,097
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $22,358
Amount paid for insurance broker fees7239
Additional information about fees paid to insurance brokerFEES PAID
Insurance broker organization code?3
ANTHEM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61069 )
Policy contract numberAL00006227
Policy instance 1
Insurance contract or identification numberAL00006227
Number of Individuals Covered959
Insurance policy start date2017-10-01
Insurance policy end date2018-09-30
Total amount of commissions paid to insurance brokerUSD $18,643
Total amount of fees paid to insurance companyUSD $4,652
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $139,779
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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