401k Plan data: PARENTS IN COMMUNITY ACTION, INC. MEDICAL PLAN plan

PARENTS IN COMMUNITY ACTION, INC. MEDICAL PLAN 401k Plan overview

Plan Name	PARENTS IN COMMUNITY ACTION, INC. MEDICAL PLAN
Plan identification number	503

PARENTS IN COMMUNITY ACTION, INC. MEDICAL PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision)

401k Sponsoring company profile

PARENTS IN COMMUNITY ACTION, INC. has sponsored the creation of one or more 401k plans.

Company Name: PARENTS IN COMMUNITY ACTION, INC.

Employer identification number (EIN): 410956226

NAIC Classification: 624100
NAIC Description: Individual and Family Services

Form 5500 Filing Information

Submission information for form 5500 for 401k plan PARENTS IN COMMUNITY ACTION, INC. MEDICAL PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
503 2022-01-01
503 2021-01-01
503 2020-01-01
503 2019-01-01
503 2018-01-01

Plan Statistics for PARENTS IN COMMUNITY ACTION, INC. MEDICAL PLAN

401k plan membership statisitcs for PARENTS IN COMMUNITY ACTION, INC. MEDICAL PLAN

Measure Date Value
2022: PARENTS IN COMMUNITY ACTION, INC. MEDICAL PLAN 2022 401k membership
Total participants, beginning-of-year 2022-01-01 305
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 251
Number of retired or separated participants receiving benefits 2022-01-01 0
Number of other retired or separated participants entitled to future benefits 2022-01-01 0
Total of all active and inactive participants 2022-01-01 251
2021: PARENTS IN COMMUNITY ACTION, INC. MEDICAL PLAN 2021 401k membership
Total participants, beginning-of-year 2021-01-01 305
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 271
Number of retired or separated participants receiving benefits 2021-01-01 34
Number of other retired or separated participants entitled to future benefits 2021-01-01 0
Total of all active and inactive participants 2021-01-01 305
2020: PARENTS IN COMMUNITY ACTION, INC. MEDICAL PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 294
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 301
Number of retired or separated participants receiving benefits 2020-01-01 4
Number of other retired or separated participants entitled to future benefits 2020-01-01 0
Total of all active and inactive participants 2020-01-01 305
2019: PARENTS IN COMMUNITY ACTION, INC. MEDICAL PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 278
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 291
Number of retired or separated participants receiving benefits 2019-01-01 3
Number of other retired or separated participants entitled to future benefits 2019-01-01 0
Total of all active and inactive participants 2019-01-01 294
2018: PARENTS IN COMMUNITY ACTION, INC. MEDICAL PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 296
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 276
Number of retired or separated participants receiving benefits 2018-01-01 2
Number of other retired or separated participants entitled to future benefits 2018-01-01 0
Total of all active and inactive participants 2018-01-01 278

Measure	Date	Value
2022: PARENTS IN COMMUNITY ACTION, INC. MEDICAL PLAN 2022 401k membership
Total participants, beginning-of-year	2022-01-01	305
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	251
Number of retired or separated participants receiving benefits	2022-01-01	0
Number of other retired or separated participants entitled to future benefits	2022-01-01	0
Total of all active and inactive participants	2022-01-01	251
2021: PARENTS IN COMMUNITY ACTION, INC. MEDICAL PLAN 2021 401k membership
Total participants, beginning-of-year	2021-01-01	305
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	271
Number of retired or separated participants receiving benefits	2021-01-01	34
Number of other retired or separated participants entitled to future benefits	2021-01-01	0
Total of all active and inactive participants	2021-01-01	305
2020: PARENTS IN COMMUNITY ACTION, INC. MEDICAL PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	294
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	301
Number of retired or separated participants receiving benefits	2020-01-01	4
Number of other retired or separated participants entitled to future benefits	2020-01-01	0
Total of all active and inactive participants	2020-01-01	305
2019: PARENTS IN COMMUNITY ACTION, INC. MEDICAL PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	278
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	291
Number of retired or separated participants receiving benefits	2019-01-01	3
Number of other retired or separated participants entitled to future benefits	2019-01-01	0
Total of all active and inactive participants	2019-01-01	294
2018: PARENTS IN COMMUNITY ACTION, INC. MEDICAL PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	296
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	276
Number of retired or separated participants receiving benefits	2018-01-01	2
Number of other retired or separated participants entitled to future benefits	2018-01-01	0
Total of all active and inactive participants	2018-01-01	278

Form 5500 Responses for PARENTS IN COMMUNITY ACTION, INC. MEDICAL PLAN

2022: PARENTS IN COMMUNITY ACTION, INC. MEDICAL PLAN 2022 form 5500 responses
2022-01-01	Type of plan entity	Single employer plan
2022-01-01	Submission has been amended	No
2022-01-01	This submission is the final filing	No
2022-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2022-01-01	Plan is a collectively bargained plan	No
2022-01-01	Plan funding arrangement – Insurance	Yes
2022-01-01	Plan benefit arrangement – Insurance	Yes
2021: PARENTS IN COMMUNITY ACTION, INC. MEDICAL PLAN 2021 form 5500 responses
2021-01-01	Type of plan entity	Single employer plan
2021-01-01	Submission has been amended	No
2021-01-01	This submission is the final filing	No
2021-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2021-01-01	Plan is a collectively bargained plan	No
2021-01-01	Plan funding arrangement – Insurance	Yes
2021-01-01	Plan benefit arrangement – Insurance	Yes
2020: PARENTS IN COMMUNITY ACTION, INC. MEDICAL PLAN 2020 form 5500 responses
2020-01-01	Type of plan entity	Single employer plan
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
2019: PARENTS IN COMMUNITY ACTION, INC. MEDICAL PLAN 2019 form 5500 responses
2019-01-01	Type of plan entity	Single employer plan
2019-01-01	Submission has been amended	No
2019-01-01	This submission is the final filing	No
2019-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2019-01-01	Plan is a collectively bargained plan	No
2019-01-01	Plan funding arrangement – Insurance	Yes
2019-01-01	Plan benefit arrangement – Insurance	Yes
2018: PARENTS IN COMMUNITY ACTION, INC. MEDICAL PLAN 2018 form 5500 responses
2018-01-01	Type of plan entity	Single employer plan
2018-01-01	First time form 5500 has been submitted	Yes
2018-01-01	Submission has been amended	No
2018-01-01	This submission is the final filing	No
2018-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2018-01-01	Plan is a collectively bargained plan	No
2018-01-01	Plan funding arrangement – Insurance	Yes
2018-01-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

HEALTHPARTNERS (National Association of Insurance Commissioners NAIC id number: 95766 )

Policy contract number

11380

Policy instance

Insurance contract or identification number	11380
Number of Individuals Covered	487
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $72,633
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	Yes
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Welfare Benefit Premiums Paid to Carrier	USD $3,575,983
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Amount paid for insurance broker fees	72633
Additional information about fees paid to insurance broker	$72,502 BROKER FEES PAID FOR MEDICAL PLAN AND $131 IN INDIRECT COMPENSATION
Insurance broker organization code?	3

HEALTHPARTNERS (National Association of Insurance Commissioners NAIC id number: 95766 )

Policy contract number

11380

Policy instance

Insurance contract or identification number	11380
Number of Individuals Covered	558
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $78,581
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	Yes
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Welfare Benefit Premiums Paid to Carrier	USD $3,875,790
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Amount paid for insurance broker fees	78581
Additional information about fees paid to insurance broker	$78,430 BROKER FEES PAID FOR MEDICAL PLAN AND $151 IN INDIRECT COMPENSATION
Insurance broker organization code?	3

HEALTHPARTNERS (National Association of Insurance Commissioners NAIC id number: 95766 )

Policy contract number

11380

Policy instance

Insurance contract or identification number	11380
Number of Individuals Covered	609
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $75,798
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	Yes
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Welfare Benefit Premiums Paid to Carrier	USD $3,741,517
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Amount paid for insurance broker fees	75798
Additional information about fees paid to insurance broker	$75,634 BROKER FEES PAID FOR MEDICAL PLAN AND $164 IN INDIRECT COMPENSATION
Insurance broker organization code?	3

HEALTHPARTNERS (National Association of Insurance Commissioners NAIC id number: 95766 )

Policy contract number

11380

Policy instance

Insurance contract or identification number	11380
Number of Individuals Covered	596
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $70,832
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	Yes
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Welfare Benefit Premiums Paid to Carrier	USD $3,417,717
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Amount paid for insurance broker fees	43089
Additional information about fees paid to insurance broker	$40,188 IN BROKER SERVICE FEE, $2,740 IN HEALTHPARTNERS AGENCY REWARDS PROGRAM AND $161 IN INDIRECT COMP
Insurance broker organization code?	3

HEALTHPARTNERS (National Association of Insurance Commissioners NAIC id number: 95766 )

Policy contract number

11380

Policy instance

Insurance contract or identification number	11380
Number of Individuals Covered	570
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $75,089
Total amount of fees paid to insurance company	USD $11,514
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	Yes
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Welfare Benefit Premiums Paid to Carrier	USD $3,286,803
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $75,089
Amount paid for insurance broker fees	11514
Additional information about fees paid to insurance broker	$11,360 IN HEALTHPARTNERS AGENCY REWARDS PROGRAM BONUS AND $154 IN INDIRECT COMPENSATION
Insurance broker organization code?	3

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Company Name:	PARENTS IN COMMUNITY ACTION, INC.
Employer identification number (EIN):	410956226
NAIC Classification:	624100
NAIC Description:	Individual and Family Services