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ORIGINS BEHAVIORAL HEALTHCARE BENEFIT PLAN 401k Plan overview

Plan NameORIGINS BEHAVIORAL HEALTHCARE BENEFIT PLAN
Plan identification number 501

ORIGINS BEHAVIORAL HEALTHCARE 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
  • Death benefits (include travel accident but not life insurance)
  • Other welfare benefit cover

401k Sponsoring company profile

ORIGINS BEHAVIORAL HEALTHCARE has sponsored the creation of one or more 401k plans.

Company Name:ORIGINS BEHAVIORAL HEALTHCARE
Employer identification number (EIN):472218788
NAIC Classification:621420
NAIC Description:Outpatient Mental Health and Substance Abuse Centers

Form 5500 Filing Information

Submission information for form 5500 for 401k plan ORIGINS BEHAVIORAL HEALTHCARE BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012017-01-01DEAN BOSWELL
5012016-01-01JERRY COPELAND
5012015-01-01

Plan Statistics for ORIGINS BEHAVIORAL HEALTHCARE BENEFIT PLAN

401k plan membership statisitcs for ORIGINS BEHAVIORAL HEALTHCARE BENEFIT PLAN

Measure Date Value
2017: ORIGINS BEHAVIORAL HEALTHCARE BENEFIT PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-01192
Total number of active participants reported on line 7a of the Form 55002017-01-010
Number of retired or separated participants receiving benefits2017-01-010
Number of other retired or separated participants entitled to future benefits2017-01-010
Total of all active and inactive participants2017-01-010
2016: ORIGINS BEHAVIORAL HEALTHCARE BENEFIT PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-01195
Total number of active participants reported on line 7a of the Form 55002016-01-01190
Number of retired or separated participants receiving benefits2016-01-012
Number of other retired or separated participants entitled to future benefits2016-01-010
Total of all active and inactive participants2016-01-01192
2015: ORIGINS BEHAVIORAL HEALTHCARE BENEFIT PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-01124
Total number of active participants reported on line 7a of the Form 55002015-01-01164
Number of retired or separated participants receiving benefits2015-01-015
Number of other retired or separated participants entitled to future benefits2015-01-0126
Total of all active and inactive participants2015-01-01195

Financial Data on ORIGINS BEHAVIORAL HEALTHCARE BENEFIT PLAN

Measure Date Value
2017 : ORIGINS BEHAVIORAL HEALTHCARE BENEFIT PLAN 2017 401k financial data
Total unrealized appreciation/depreciation of assets2017-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$0
Total income from all sources (including contributions)2017-12-31$2,417,107
Total loss/gain on sale of assets2017-12-31$0
Total of all expenses incurred2017-12-31$2,677,821
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2017-12-31$2,443,576
Total contributions o plan (from employers,participants, others, non cash contrinutions)2017-12-31$2,416,672
Value of total assets at end of year2017-12-31$6,894
Value of total assets at beginning of year2017-12-31$267,608
Total of administrative expenses incurred including professional, contract, advisory and management fees2017-12-31$234,245
Total interest from all sources2017-12-31$435
Total dividends received (eg from common stock, registered investment company shares)2017-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2017-12-31No
Was this plan covered by a fidelity bond2017-12-31Yes
Value of fidelity bond cover2017-12-31$500,000
If this is an individual account plan, was there a blackout period2017-12-31No
Were there any nonexempt tranactions with any party-in-interest2017-12-31No
Contributions received from participants2017-12-31$722,852
Income. Received or receivable in cash from other sources (including rollovers)2017-12-31$564,519
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2017-12-31$1,814,509
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Value of net income/loss2017-12-31$-260,714
Value of net assets at end of year (total assets less liabilities)2017-12-31$6,894
Value of net assets at beginning of year (total assets less liabilities)2017-12-31$267,608
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2017-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2017-12-31No
Were any leases to which the plan was party in default or uncollectible2017-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2017-12-31$6,894
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2017-12-31$267,608
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2017-12-31$267,608
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2017-12-31$435
Expenses. Payments to insurance carriers foe the provision of benefits2017-12-31$629,067
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2017-12-31No
Was there a failure to transmit to the plan any participant contributions2017-12-31No
Has the plan failed to provide any benefit when due under the plan2017-12-31No
Contributions received in cash from employer2017-12-31$1,129,301
Contract administrator fees2017-12-31$234,245
Did the plan have assets held for investment2017-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2017-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2017-12-31No
Opinion of an independent qualified public accountant for this plan2017-12-31Unqualified
Accountancy firm name2017-12-31FARMER, FUQUA & HUFF P.C.
Accountancy firm EIN2017-12-31752599166
2016 : ORIGINS BEHAVIORAL HEALTHCARE BENEFIT PLAN 2016 401k financial data
Total unrealized appreciation/depreciation of assets2016-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$0
Total income from all sources (including contributions)2016-12-31$1,836,719
Total loss/gain on sale of assets2016-12-31$0
Total of all expenses incurred2016-12-31$1,569,111
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2016-12-31$1,355,183
Total contributions o plan (from employers,participants, others, non cash contrinutions)2016-12-31$1,836,336
Value of total assets at end of year2016-12-31$267,608
Value of total assets at beginning of year2016-12-31$0
Total of administrative expenses incurred including professional, contract, advisory and management fees2016-12-31$213,928
Total interest from all sources2016-12-31$383
Total dividends received (eg from common stock, registered investment company shares)2016-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2016-12-31No
Was this plan covered by a fidelity bond2016-12-31Yes
Value of fidelity bond cover2016-12-31$500,000
If this is an individual account plan, was there a blackout period2016-12-31No
Were there any nonexempt tranactions with any party-in-interest2016-12-31No
Contributions received from participants2016-12-31$742,876
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2016-12-31$836,457
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Value of net income/loss2016-12-31$267,608
Value of net assets at end of year (total assets less liabilities)2016-12-31$267,608
Value of net assets at beginning of year (total assets less liabilities)2016-12-31$0
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2016-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2016-12-31No
Were any leases to which the plan was party in default or uncollectible2016-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2016-12-31$267,608
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2016-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2016-12-31$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2016-12-31$383
Expenses. Payments to insurance carriers foe the provision of benefits2016-12-31$518,726
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2016-12-31No
Was there a failure to transmit to the plan any participant contributions2016-12-31No
Has the plan failed to provide any benefit when due under the plan2016-12-31No
Contributions received in cash from employer2016-12-31$1,093,460
Contract administrator fees2016-12-31$213,928
Did the plan have assets held for investment2016-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2016-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2016-12-31No
Opinion of an independent qualified public accountant for this plan2016-12-31Unqualified
Accountancy firm name2016-12-31FARMER, FUQUA & HUFF P.C.
Accountancy firm EIN2016-12-31752599166

Form 5500 Responses for ORIGINS BEHAVIORAL HEALTHCARE BENEFIT PLAN

2017: ORIGINS BEHAVIORAL HEALTHCARE BENEFIT PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
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 – InsuranceYes
2017-01-01Plan funding arrangement – TrustYes
2017-01-01Plan benefit arrangement – InsuranceYes
2017-01-01Plan benefit arrangement - TrustYes
2016: ORIGINS BEHAVIORAL HEALTHCARE BENEFIT PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Submission has been amendedNo
2016-01-01This submission is the final filingNo
2016-01-01This return/report is a short plan year return/report (less than 12 months)No
2016-01-01Plan is a collectively bargained planNo
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan funding arrangement – TrustYes
2016-01-01Plan benefit arrangement – InsuranceYes
2016-01-01Plan benefit arrangement - TrustYes
2015: ORIGINS BEHAVIORAL HEALTHCARE BENEFIT PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01First time form 5500 has been submittedYes
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract numberTM05924532
Policy instance 1
Insurance contract or identification numberTM05924532
Number of Individuals Covered335
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $22,790
Total amount of fees paid to insurance companyUSD $3,015
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedAD&D
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 CarrierUSD $242,151
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $13,226
Amount paid for insurance broker fees1894
Additional information about fees paid to insurance brokerSUPPLEMENTAL COMPENSATION
Insurance broker organization code?3
Insurance broker nameALLIANT INS SERVICES INC
EVEREST REINSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract numberVERIS
Policy instance 2
Insurance contract or identification numberVERIS
Number of Individuals Covered182
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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 CarrierUSD $386,916
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number901615
Policy instance 1
Insurance contract or identification number901615
Number of Individuals Covered196
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $38,008
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $911,469
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees38008
Additional information about fees paid to insurance brokerSERVICE FEES AGREEMENT
Insurance broker organization code?3
Insurance broker nameENGLE-HAMBRIGHT & DAVIES INC
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract numberTM05924532
Policy instance 2
Insurance contract or identification numberTM05924532
Number of Individuals Covered228
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $22,340
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $190,646
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $19,739
Insurance broker organization code?3
Insurance broker nameASSUREX AGENCY INC

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