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HEALTH REIMBURSEMENT ARRANGEMENT 401k Plan overview

Plan NameHEALTH REIMBURSEMENT ARRANGEMENT
Plan identification number 502

HEALTH REIMBURSEMENT ARRANGEMENT Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Dental
  • Other welfare benefit cover

401k Sponsoring company profile

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

Company Name:PERFORMANCE SERVICES, INC.
Employer identification number (EIN):352047928
NAIC Classification:238220
NAIC Description:Plumbing, Heating, and Air-Conditioning Contractors

Form 5500 Filing Information

Submission information for form 5500 for 401k plan HEALTH REIMBURSEMENT ARRANGEMENT

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5022017-11-01KIMBERLY MOUTON KIMBERLY MOUTON2018-07-03
5022017-01-01JOSHUA DRAKE
5022016-11-01KIMBERLY MOUTON KIMBERLY MOUTON2018-05-25

Plan Statistics for HEALTH REIMBURSEMENT ARRANGEMENT

401k plan membership statisitcs for HEALTH REIMBURSEMENT ARRANGEMENT

Measure Date Value
2017: HEALTH REIMBURSEMENT ARRANGEMENT 2017 401k membership
Total participants, beginning-of-year2017-11-01135
Total number of active participants reported on line 7a of the Form 55002017-11-010
Number of retired or separated participants receiving benefits2017-11-010
Number of other retired or separated participants entitled to future benefits2017-11-010
Total of all active and inactive participants2017-11-010
Total participants, beginning-of-year2017-01-01112
Total number of active participants reported on line 7a of the Form 55002017-01-01131
Number of retired or separated participants receiving benefits2017-01-018
Number of other retired or separated participants entitled to future benefits2017-01-010
Total of all active and inactive participants2017-01-01139
2016: HEALTH REIMBURSEMENT ARRANGEMENT 2016 401k membership
Total participants, beginning-of-year2016-11-01111
Total number of active participants reported on line 7a of the Form 55002016-11-01134
Number of retired or separated participants receiving benefits2016-11-011
Number of other retired or separated participants entitled to future benefits2016-11-010
Total of all active and inactive participants2016-11-01135

Form 5500 Responses for HEALTH REIMBURSEMENT ARRANGEMENT

2017: HEALTH REIMBURSEMENT ARRANGEMENT 2017 form 5500 responses
2017-11-01Type of plan entitySingle employer plan
2017-11-01Submission has been amendedNo
2017-11-01This submission is the final filingYes
2017-11-01This return/report is a short plan year return/report (less than 12 months)Yes
2017-11-01Plan is a collectively bargained planNo
2017-11-01Plan funding arrangement – InsuranceYes
2017-11-01Plan benefit arrangement – InsuranceYes
2017-01-01Type of plan entitySingle employer plan
2017-01-01First time form 5500 has been submittedYes
2017-01-01Submission has been amendedNo
2017-01-01This submission is the final filingNo
2017-01-01This return/report is a short plan year return/report (less than 12 months)No
2017-01-01Plan is a collectively bargained planNo
2017-01-01Plan funding arrangement – General assets of the sponsorYes
2017-01-01Plan benefit arrangement – General assets of the sponsorYes
2016: HEALTH REIMBURSEMENT ARRANGEMENT 2016 form 5500 responses
2016-11-01Type of plan entitySingle employer plan
2016-11-01First time form 5500 has been submittedYes
2016-11-01Submission has been amendedNo
2016-11-01This submission is the final filingNo
2016-11-01This return/report is a short plan year return/report (less than 12 months)No
2016-11-01Plan is a collectively bargained planNo
2016-11-01Plan funding arrangement – InsuranceYes
2016-11-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

ANTHEM INSURANCE COMPANIES, INC (National Association of Insurance Commissioners NAIC id number: 28207 )
Policy contract number818179
Policy instance 1
Insurance contract or identification number818179
Number of Individuals Covered138
Insurance policy start date2017-11-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $1,883
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $18,831
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,883
Insurance broker organization code?3
Insurance broker nameLOCASCIO HADDEN & DENNIS LLC

Potentially related plans

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