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BEHAVIORAL HEALTH RESPONSE WELFARE BENEFIT PLAN 401k Plan overview

Plan NameBEHAVIORAL HEALTH RESPONSE WELFARE BENEFIT PLAN
Plan identification number 501

BEHAVIORAL HEALTH RESPONSE WELFARE BENEFIT PLAN Benefits

401k Plan TypeWelfare 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

BEHAVIORAL HEALTH RESPONSE, INC. has sponsored the creation of one or more 401k plans.

Company Name:BEHAVIORAL HEALTH RESPONSE, INC.
Employer identification number (EIN):431718980
NAIC Classification:813000
NAIC Description: Religious, Grantmaking, Civic, Professional, and Similar Organizations

Form 5500 Filing Information

Submission information for form 5500 for 401k plan BEHAVIORAL HEALTH RESPONSE WELFARE BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012022-01-01SAMUEL FREDEKING2023-07-25 SAMUEL FREDEKING2023-07-25
5012021-01-01SAMUEL FREDEKING2022-07-11 SAMUEL FREDEKING2022-07-11

Plan Statistics for BEHAVIORAL HEALTH RESPONSE WELFARE BENEFIT PLAN

401k plan membership statisitcs for BEHAVIORAL HEALTH RESPONSE WELFARE BENEFIT PLAN

Measure Date Value
2022: BEHAVIORAL HEALTH RESPONSE WELFARE BENEFIT PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-01106
Total number of active participants reported on line 7a of the Form 55002022-01-01111
Total of all active and inactive participants2022-01-01111
2021: BEHAVIORAL HEALTH RESPONSE WELFARE BENEFIT PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-0195
Total number of active participants reported on line 7a of the Form 55002021-01-01106
Total of all active and inactive participants2021-01-01106

Form 5500 Responses for BEHAVIORAL HEALTH RESPONSE WELFARE BENEFIT PLAN

2022: BEHAVIORAL HEALTH RESPONSE WELFARE BENEFIT PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan funding arrangement – General assets of the sponsorYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement – General assets of the sponsorYes
2021: BEHAVIORAL HEALTH RESPONSE WELFARE BENEFIT PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01First time form 5500 has been submittedYes
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan funding arrangement – General assets of the sponsorYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number944241
Policy instance 1
Insurance contract or identification number944241
Number of Individuals Covered114
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $38,815
Total amount of fees paid to insurance companyUSD $0
Welfare Benefit Premiums Paid to CarrierUSD $413,796
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $38,815
Insurance broker organization code?7
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number935009
Policy instance 2
Insurance contract or identification number935009
Number of Individuals Covered158
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $26,380
Total amount of fees paid to insurance companyUSD $15,558
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $208,522
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $26,380
Amount paid for insurance broker fees15558
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
SUN LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80926 )
Policy contract numberB1121-1
Policy instance 3
Insurance contract or identification numberB1121-1
Number of Individuals Covered111
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $41,692
Total amount of fees paid to insurance companyUSD $52,637
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $375,279
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $41,692
Amount paid for insurance broker fees52637
Additional information about fees paid to insurance brokerADMIN FEES, PPO FEES, UTILIZATION REVIEW & COBRA FEES
Insurance broker organization code?3
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number944241
Policy instance 1
Insurance contract or identification number944241
Number of Individuals Covered104
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $32,292
Total amount of fees paid to insurance companyUSD $0
Welfare Benefit Premiums Paid to CarrierUSD $325,909
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $32,292
Insurance broker organization code?3
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number935009
Policy instance 2
Insurance contract or identification number935009
Number of Individuals Covered100
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $4,589
Total amount of fees paid to insurance companyUSD $3,372
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $74,751
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,589
Amount paid for insurance broker fees3372
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
SUN LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80926 )
Policy contract numberB1121-1
Policy instance 3
Insurance contract or identification numberB1121-1
Number of Individuals Covered106
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $32,598
Total amount of fees paid to insurance companyUSD $45,424
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $293,318
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $32,598
Amount paid for insurance broker fees45424
Additional information about fees paid to insurance brokerADMIN FEES, PPO FEES, UTILIZATION REVIEW & COBRA FEES
Insurance broker organization code?3

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