401k Plan data: PROVIDENCE BEHAVIORAL HEALTH PA 401K PLAN plan

PROVIDENCE BEHAVIORAL HEALTH PA 401K PLAN 401k Plan overview

Plan Name	PROVIDENCE BEHAVIORAL HEALTH PA 401K PLAN
Plan identification number	001

PROVIDENCE BEHAVIORAL HEALTH PA 401K PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

Age/Service Weighted or new comparability or similar plan - Age/Service Weighted Plan: Allocations are based on age, service, or age and service. New comparability or similar plan: Allocations are based on participant classifications and a classification(s) consists entirely or predominantly of highly compensated employees; or the plan provides an additional allocation rate on compensation above a specified threshold, and the theshold or additional rate exceeds the maximum threshold or rate allowed under the permitted disparity rules of section 401(l).
Profit-sharing
ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
Participant-directed brokerage accounts provided as an investment option under the plan.
Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.
Prototype plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion or notification letter; and under which a seperate funding medium (for example, a seperate trust or custodial account) is established for the use of each adopting employer.

401k Sponsoring company profile

PROVIDENCE BEHAVIORAL HEALTH PA has sponsored the creation of one or more 401k plans.

Company Name: PROVIDENCE BEHAVIORAL HEALTH PA

Employer identification number (EIN): 562120015

NAIC Classification: 621112
NAIC Description: Offices of Physicians, Mental Health Specialists

Form 5500 Filing Information

Submission information for form 5500 for 401k plan PROVIDENCE BEHAVIORAL HEALTH PA 401K PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2022-01-01
001 2021-01-01
001 2021-01-01
001 2020-01-01
001 2019-01-01 PREETINDER BRAR 2020-07-02 PREETINDER BRAR 2020-07-02
001 2018-01-01 PREETINDER BRAR 2019-02-08 PREETINDER BRAR 2019-02-08
001 2017-01-01 PREETINDER BRAR 2018-04-12 PREETINDER BRAR 2018-04-12
001 2016-01-01 PREETINDER BRAR 2017-03-31 PREETINDER BRAR 2017-03-31
001 2015-01-01 PREETINDER BRAR 2016-04-13 PREETINDER BRAR 2016-04-13
001 2014-01-01 PREETINDER BRAR 2015-05-06 PREETINDER BRAR 2015-05-06
001 2013-01-01 PREETINDER BRAR 2014-10-14 PREETINDER BRAR 2014-10-14
001 2012-01-01 PREETINDER BRAR 2013-10-14 PREETINDER BRAR 2013-10-14
001 2011-01-01 PREETINDER BRAR 2013-10-14 PREETINDER BRAR 2013-10-14
001 2010-01-01 PREETINDER BRAR 2013-03-08
001 2008-01-01 PREETINDER BRAR
001 2007-01-01 PREETINDER BRAR
001 2006-01-01 PREETINDER BRAR
001 2005-01-01 PREETINDER BRAR
001 2004-01-01 PREETINDER BRAR
001 2003-01-01 PREETINDER BRAR

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
001	2022-01-01
001	2021-01-01
001	2021-01-01
001	2020-01-01
001	2019-01-01	PREETINDER BRAR	2020-07-02	PREETINDER BRAR	2020-07-02
001	2018-01-01	PREETINDER BRAR	2019-02-08	PREETINDER BRAR	2019-02-08
001	2017-01-01	PREETINDER BRAR	2018-04-12	PREETINDER BRAR	2018-04-12
001	2016-01-01	PREETINDER BRAR	2017-03-31	PREETINDER BRAR	2017-03-31
001	2015-01-01	PREETINDER BRAR	2016-04-13	PREETINDER BRAR	2016-04-13
001	2014-01-01	PREETINDER BRAR	2015-05-06	PREETINDER BRAR	2015-05-06
001	2013-01-01	PREETINDER BRAR	2014-10-14	PREETINDER BRAR	2014-10-14
001	2012-01-01	PREETINDER BRAR	2013-10-14	PREETINDER BRAR	2013-10-14
001	2011-01-01	PREETINDER BRAR	2013-10-14	PREETINDER BRAR	2013-10-14
001	2010-01-01	PREETINDER BRAR	2013-03-08
001	2008-01-01	PREETINDER BRAR
001	2007-01-01	PREETINDER BRAR
001	2006-01-01	PREETINDER BRAR
001	2005-01-01	PREETINDER BRAR
001	2004-01-01	PREETINDER BRAR
001	2003-01-01	PREETINDER BRAR

Plan Statistics for PROVIDENCE BEHAVIORAL HEALTH PA 401K PLAN

401k plan membership statisitcs for PROVIDENCE BEHAVIORAL HEALTH PA 401K PLAN

Measure Date Value
2008: PROVIDENCE BEHAVIORAL HEALTH PA 401K PLAN 2008 401k membership
Total participants, beginning-of-year 2008-01-01 3
Total number of active participants reported on line 7a of the Form 5500 2008-01-01 3
Number of retired or separated participants receiving benefits 2008-01-01 0
Number of other retired or separated participants entitled to future benefits 2008-01-01 0
Total of all active and inactive participants 2008-01-01 3
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2008-01-01 0
Total participants 2008-01-01 3
Number of participants with account balances 2008-01-01 3
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2008-01-01 0
2007: PROVIDENCE BEHAVIORAL HEALTH PA 401K PLAN 2007 401k membership
Total participants, beginning-of-year 2007-01-01 3
Total number of active participants reported on line 7a of the Form 5500 2007-01-01 3
Number of retired or separated participants receiving benefits 2007-01-01 0
Number of other retired or separated participants entitled to future benefits 2007-01-01 0
Total of all active and inactive participants 2007-01-01 3
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2007-01-01 0
Total participants 2007-01-01 3
Number of participants with account balances 2007-01-01 3
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2007-01-01 0
2006: PROVIDENCE BEHAVIORAL HEALTH PA 401K PLAN 2006 401k membership
Total participants, beginning-of-year 2006-01-01 2
Total number of active participants reported on line 7a of the Form 5500 2006-01-01 3
Number of retired or separated participants receiving benefits 2006-01-01 0
Number of other retired or separated participants entitled to future benefits 2006-01-01 0
Total of all active and inactive participants 2006-01-01 3
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2006-01-01 0
Total participants 2006-01-01 3
Number of participants with account balances 2006-01-01 3
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2006-01-01 0
2005: PROVIDENCE BEHAVIORAL HEALTH PA 401K PLAN 2005 401k membership
Total participants, beginning-of-year 2005-01-01 2
Total number of active participants reported on line 7a of the Form 5500 2005-01-01 2
Number of retired or separated participants receiving benefits 2005-01-01 0
Number of other retired or separated participants entitled to future benefits 2005-01-01 0
Total of all active and inactive participants 2005-01-01 2
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2005-01-01 0
Total participants 2005-01-01 2
Number of participants with account balances 2005-01-01 2
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2005-01-01 0
2004: PROVIDENCE BEHAVIORAL HEALTH PA 401K PLAN 2004 401k membership
Total participants, beginning-of-year 2004-01-01 2
Total number of active participants reported on line 7a of the Form 5500 2004-01-01 2
Number of retired or separated participants receiving benefits 2004-01-01 0
Number of other retired or separated participants entitled to future benefits 2004-01-01 0
Total of all active and inactive participants 2004-01-01 2
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2004-01-01 0
Total participants 2004-01-01 2
Number of participants with account balances 2004-01-01 2
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2004-01-01 0
2003: PROVIDENCE BEHAVIORAL HEALTH PA 401K PLAN 2003 401k membership
Total participants, beginning-of-year 2003-01-01 2
Total number of active participants reported on line 7a of the Form 5500 2003-01-01 2
Number of retired or separated participants receiving benefits 2003-01-01 0
Number of other retired or separated participants entitled to future benefits 2003-01-01 0
Total of all active and inactive participants 2003-01-01 2
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2003-01-01 0
Total participants 2003-01-01 2
Number of participants with account balances 2003-01-01 2
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2003-01-01 0

Measure	Date	Value
2008: PROVIDENCE BEHAVIORAL HEALTH PA 401K PLAN 2008 401k membership
Total participants, beginning-of-year	2008-01-01	3
Total number of active participants reported on line 7a of the Form 5500	2008-01-01	3
Number of retired or separated participants receiving benefits	2008-01-01	0
Number of other retired or separated participants entitled to future benefits	2008-01-01	0
Total of all active and inactive participants	2008-01-01	3
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2008-01-01	0
Total participants	2008-01-01	3
Number of participants with account balances	2008-01-01	3
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2008-01-01	0
2007: PROVIDENCE BEHAVIORAL HEALTH PA 401K PLAN 2007 401k membership
Total participants, beginning-of-year	2007-01-01	3
Total number of active participants reported on line 7a of the Form 5500	2007-01-01	3
Number of retired or separated participants receiving benefits	2007-01-01	0
Number of other retired or separated participants entitled to future benefits	2007-01-01	0
Total of all active and inactive participants	2007-01-01	3
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2007-01-01	0
Total participants	2007-01-01	3
Number of participants with account balances	2007-01-01	3
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2007-01-01	0
2006: PROVIDENCE BEHAVIORAL HEALTH PA 401K PLAN 2006 401k membership
Total participants, beginning-of-year	2006-01-01	2
Total number of active participants reported on line 7a of the Form 5500	2006-01-01	3
Number of retired or separated participants receiving benefits	2006-01-01	0
Number of other retired or separated participants entitled to future benefits	2006-01-01	0
Total of all active and inactive participants	2006-01-01	3
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2006-01-01	0
Total participants	2006-01-01	3
Number of participants with account balances	2006-01-01	3
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2006-01-01	0
2005: PROVIDENCE BEHAVIORAL HEALTH PA 401K PLAN 2005 401k membership
Total participants, beginning-of-year	2005-01-01	2
Total number of active participants reported on line 7a of the Form 5500	2005-01-01	2
Number of retired or separated participants receiving benefits	2005-01-01	0
Number of other retired or separated participants entitled to future benefits	2005-01-01	0
Total of all active and inactive participants	2005-01-01	2
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2005-01-01	0
Total participants	2005-01-01	2
Number of participants with account balances	2005-01-01	2
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2005-01-01	0
2004: PROVIDENCE BEHAVIORAL HEALTH PA 401K PLAN 2004 401k membership
Total participants, beginning-of-year	2004-01-01	2
Total number of active participants reported on line 7a of the Form 5500	2004-01-01	2
Number of retired or separated participants receiving benefits	2004-01-01	0
Number of other retired or separated participants entitled to future benefits	2004-01-01	0
Total of all active and inactive participants	2004-01-01	2
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2004-01-01	0
Total participants	2004-01-01	2
Number of participants with account balances	2004-01-01	2
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2004-01-01	0
2003: PROVIDENCE BEHAVIORAL HEALTH PA 401K PLAN 2003 401k membership
Total participants, beginning-of-year	2003-01-01	2
Total number of active participants reported on line 7a of the Form 5500	2003-01-01	2
Number of retired or separated participants receiving benefits	2003-01-01	0
Number of other retired or separated participants entitled to future benefits	2003-01-01	0
Total of all active and inactive participants	2003-01-01	2
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2003-01-01	0
Total participants	2003-01-01	2
Number of participants with account balances	2003-01-01	2
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2003-01-01	0

Financial Data on PROVIDENCE BEHAVIORAL HEALTH PA 401K PLAN

Measure	Date	Value
2008 : PROVIDENCE BEHAVIORAL HEALTH PA 401K PLAN 2008 401k financial data
Transfers to/from the plan	2008-12-31	$0
Total income from all sources	2008-12-31	$4,104
Expenses. Total of all expenses incurred	2008-12-31	$160
Benefits paid (including direct rollovers)	2008-12-31	$0
Total plan assets at end of year	2008-12-31	$389,540
Total plan assets at beginning of year	2008-12-31	$385,596
Total contributions received or receivable from participants	2008-12-31	$21,905
Expenses. Other expenses not covered elsewhere	2008-12-31	$0
Contributions received from other sources (not participants or employers)	2008-12-31	$0
Other income received	2008-12-31	$-17,801
Noncash contributions received	2008-12-31	$0
Net income (gross income less expenses)	2008-12-31	$3,944
Net plan assets at end of year (total assets less liabilities)	2008-12-31	$389,540
Net plan assets at beginning of year (total assets less liabilities)	2008-12-31	$385,596
Total contributions received or receivable from employer(s)	2008-12-31	$0
Value of certain deemed distributions of participant loans	2008-12-31	$0
Value of corrective distributions	2008-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2008-12-31	$160
2007 : PROVIDENCE BEHAVIORAL HEALTH PA 401K PLAN 2007 401k financial data
Transfers to/from the plan	2007-12-31	$0
Total income from all sources	2007-12-31	$94,096
Expenses. Total of all expenses incurred	2007-12-31	$160
Benefits paid (including direct rollovers)	2007-12-31	$0
Total plan assets at end of year	2007-12-31	$385,596
Total plan assets at beginning of year	2007-12-31	$291,660
Total contributions received or receivable from participants	2007-12-31	$30,650
Expenses. Other expenses not covered elsewhere	2007-12-31	$0
Contributions received from other sources (not participants or employers)	2007-12-31	$0
Other income received	2007-12-31	$45,586
Noncash contributions received	2007-12-31	$0
Net income (gross income less expenses)	2007-12-31	$93,936
Net plan assets at end of year (total assets less liabilities)	2007-12-31	$385,596
Net plan assets at beginning of year (total assets less liabilities)	2007-12-31	$291,660
Total contributions received or receivable from employer(s)	2007-12-31	$17,860
Value of certain deemed distributions of participant loans	2007-12-31	$0
Value of corrective distributions	2007-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2007-12-31	$160
2006 : PROVIDENCE BEHAVIORAL HEALTH PA 401K PLAN 2006 401k financial data
Transfers to/from the plan	2006-12-31	$0
Total income from all sources	2006-12-31	$69,710
Expenses. Total of all expenses incurred	2006-12-31	$160
Benefits paid (including direct rollovers)	2006-12-31	$0
Total plan assets at end of year	2006-12-31	$291,660
Total plan assets at beginning of year	2006-12-31	$222,110
Total contributions received or receivable from participants	2006-12-31	$21,300
Expenses. Other expenses not covered elsewhere	2006-12-31	$0
Contributions received from other sources (not participants or employers)	2006-12-31	$0
Other income received	2006-12-31	$18,822
Noncash contributions received	2006-12-31	$0
Net income (gross income less expenses)	2006-12-31	$69,550
Net plan assets at end of year (total assets less liabilities)	2006-12-31	$291,660
Net plan assets at beginning of year (total assets less liabilities)	2006-12-31	$222,110
Total contributions received or receivable from employer(s)	2006-12-31	$29,588
Value of certain deemed distributions of participant loans	2006-12-31	$0
Value of corrective distributions	2006-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2006-12-31	$160
2005 : PROVIDENCE BEHAVIORAL HEALTH PA 401K PLAN 2005 401k financial data
Transfers to/from the plan	2005-12-31	$0
Total income from all sources	2005-12-31	$15,077
Expenses. Total of all expenses incurred	2005-12-31	$160
Benefits paid (including direct rollovers)	2005-12-31	$0
Total plan assets at end of year	2005-12-31	$222,110
Total plan assets at beginning of year	2005-12-31	$207,193
Total contributions received or receivable from participants	2005-12-31	$22,000
Expenses. Other expenses not covered elsewhere	2005-12-31	$0
Contributions received from other sources (not participants or employers)	2005-12-31	$0
Other income received	2005-12-31	$-42,858
Noncash contributions received	2005-12-31	$0
Net income (gross income less expenses)	2005-12-31	$14,917
Net plan assets at end of year (total assets less liabilities)	2005-12-31	$222,110
Net plan assets at beginning of year (total assets less liabilities)	2005-12-31	$207,193
Total contributions received or receivable from employer(s)	2005-12-31	$35,935
Value of certain deemed distributions of participant loans	2005-12-31	$0
Value of corrective distributions	2005-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2005-12-31	$160
2004 : PROVIDENCE BEHAVIORAL HEALTH PA 401K PLAN 2004 401k financial data
Transfers to/from the plan	2004-12-31	$0
Total income from all sources	2004-12-31	$118,936
Expenses. Total of all expenses incurred	2004-12-31	$160
Benefits paid (including direct rollovers)	2004-12-31	$0
Total plan assets at end of year	2004-12-31	$207,193
Total plan assets at beginning of year	2004-12-31	$88,417
Total contributions received or receivable from participants	2004-12-31	$26,000
Expenses. Other expenses not covered elsewhere	2004-12-31	$0
Contributions received from other sources (not participants or employers)	2004-12-31	$0
Other income received	2004-12-31	$61,609
Noncash contributions received	2004-12-31	$0
Net income (gross income less expenses)	2004-12-31	$118,776
Net plan assets at end of year (total assets less liabilities)	2004-12-31	$207,193
Net plan assets at beginning of year (total assets less liabilities)	2004-12-31	$88,417
Total contributions received or receivable from employer(s)	2004-12-31	$31,327
Value of certain deemed distributions of participant loans	2004-12-31	$0
Value of corrective distributions	2004-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2004-12-31	$160
2003 : PROVIDENCE BEHAVIORAL HEALTH PA 401K PLAN 2003 401k financial data
Transfers to/from the plan	2003-12-31	$30,126
Total income from all sources	2003-12-31	$30,132
Expenses. Total of all expenses incurred	2003-12-31	$160
Benefits paid (including direct rollovers)	2003-12-31	$0
Total plan assets at end of year	2003-12-31	$88,417
Total plan assets at beginning of year	2003-12-31	$28,319
Total contributions received or receivable from participants	2003-12-31	$17,000
Expenses. Other expenses not covered elsewhere	2003-12-31	$0
Contributions received from other sources (not participants or employers)	2003-12-31	$0
Other income received	2003-12-31	$632
Noncash contributions received	2003-12-31	$0
Net income (gross income less expenses)	2003-12-31	$29,972
Net plan assets at end of year (total assets less liabilities)	2003-12-31	$88,417
Net plan assets at beginning of year (total assets less liabilities)	2003-12-31	$28,319
Total contributions received or receivable from employer(s)	2003-12-31	$12,500
Value of certain deemed distributions of participant loans	2003-12-31	$0
Value of corrective distributions	2003-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2003-12-31	$160

Form 5500 Responses for PROVIDENCE BEHAVIORAL HEALTH PA 401K PLAN

2008: PROVIDENCE BEHAVIORAL HEALTH PA 401K PLAN 2008 form 5500 responses
2008-01-01	Type of plan entity	Single employer plan
2008-01-01	Submission has been amended	No
2008-01-01	This submission is the final filing	No
2008-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2008-01-01	Plan is a collectively bargained plan	No
2007: PROVIDENCE BEHAVIORAL HEALTH PA 401K PLAN 2007 form 5500 responses
2007-01-01	Type of plan entity	Single employer plan
2007-01-01	Submission has been amended	No
2007-01-01	This submission is the final filing	No
2007-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2007-01-01	Plan is a collectively bargained plan	No
2006: PROVIDENCE BEHAVIORAL HEALTH PA 401K PLAN 2006 form 5500 responses
2006-01-01	Type of plan entity	Single employer plan
2006-01-01	Submission has been amended	No
2006-01-01	This submission is the final filing	No
2006-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2006-01-01	Plan is a collectively bargained plan	No
2005: PROVIDENCE BEHAVIORAL HEALTH PA 401K PLAN 2005 form 5500 responses
2005-01-01	Type of plan entity	Single employer plan
2005-01-01	Submission has been amended	No
2005-01-01	This submission is the final filing	No
2005-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2005-01-01	Plan is a collectively bargained plan	No
2004: PROVIDENCE BEHAVIORAL HEALTH PA 401K PLAN 2004 form 5500 responses
2004-01-01	Type of plan entity	Single employer plan
2004-01-01	Submission has been amended	No
2004-01-01	This submission is the final filing	No
2004-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2004-01-01	Plan is a collectively bargained plan	No
2003: PROVIDENCE BEHAVIORAL HEALTH PA 401K PLAN 2003 form 5500 responses
2003-01-01	Type of plan entity	Single employer plan
2003-01-01	Submission has been amended	No
2003-01-01	This submission is the final filing	No
2003-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2003-01-01	Plan is a collectively bargained plan	No

Insurance Providers Used on plan

METLIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 87726 )

Policy contract number

935821

Policy instance

Insurance contract or identification number	935821
Number of Individuals Covered	2
Insurance policy start date	2003-01-01
Insurance policy end date	2003-12-31
Total amount of commissions paid to insurance broker	USD $1,109
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for group deferred annuity?	Yes
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,109
Insurance broker name	SCOTT STORICK

Potentially related plans

PROVIDENCE BEHAVIORAL HEALTH 401 K PROFIT SHARING PLAN TRUST [EIN = 208058168]

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Company Name:	PROVIDENCE BEHAVIORAL HEALTH PA
Employer identification number (EIN):	562120015
NAIC Classification:	621112
NAIC Description:	Offices of Physicians, Mental Health Specialists