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| Plan Name | ALLIANCE HEALTHCARE SERVICES LIFE, DISABILITY, AND ACCIDENTAL DEATH WELFARE BENEFIT PLAN |
| Plan identification number | 501 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | ALLIANCE HEALTHCARE SERVICES BENEFIT PLAN |
| Employer identification number (EIN): | 620911518 |
| NAIC Classification: | 621420 |
| NAIC Description: | Outpatient Mental Health and Substance Abuse Centers |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 501 | 2020-10-01 | LAURIE POWELL | 2022-05-24 | ||
| 501 | 2019-10-01 | LAURIE POWELL | 2021-04-13 | ||
| 501 | 2014-10-01 |
| Measure | Date | Value |
|---|---|---|
| 2020: ALLIANCE HEALTHCARE SERVICES LIFE, DISABILITY, AND ACCIDENTAL DEATH WELFARE BENEFIT PLAN 2020 401k membership | ||
| Total participants, beginning-of-year | 2020-10-01 | 344 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-10-01 | 347 |
| Total of all active and inactive participants | 2020-10-01 | 347 |
| 2019: ALLIANCE HEALTHCARE SERVICES LIFE, DISABILITY, AND ACCIDENTAL DEATH WELFARE BENEFIT PLAN 2019 401k membership | ||
| Total participants, beginning-of-year | 2019-10-01 | 340 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-10-01 | 344 |
| Total of all active and inactive participants | 2019-10-01 | 344 |
| 2014: ALLIANCE HEALTHCARE SERVICES LIFE, DISABILITY, AND ACCIDENTAL DEATH WELFARE BENEFIT PLAN 2014 401k membership | ||
| Total participants, beginning-of-year | 2014-10-01 | 277 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-10-01 | 277 |
| Total of all active and inactive participants | 2014-10-01 | 277 |
| 2020: ALLIANCE HEALTHCARE SERVICES LIFE, DISABILITY, AND ACCIDENTAL DEATH WELFARE BENEFIT PLAN 2020 form 5500 responses | ||
|---|---|---|
| 2020-10-01 | Type of plan entity | Single employer plan |
| 2020-10-01 | Plan funding arrangement – Insurance | Yes |
| 2020-10-01 | Plan benefit arrangement – Insurance | Yes |
| 2019: ALLIANCE HEALTHCARE SERVICES LIFE, DISABILITY, AND ACCIDENTAL DEATH WELFARE BENEFIT PLAN 2019 form 5500 responses | ||
| 2019-10-01 | Type of plan entity | Single employer plan |
| 2019-10-01 | Plan funding arrangement – Insurance | Yes |
| 2019-10-01 | Plan benefit arrangement – Insurance | Yes |
| 2014: ALLIANCE HEALTHCARE SERVICES LIFE, DISABILITY, AND ACCIDENTAL DEATH WELFARE BENEFIT PLAN 2014 form 5500 responses | ||
| 2014-10-01 | Type of plan entity | Single employer plan |
| 2014-10-01 | First time form 5500 has been submitted | Yes |
| 2014-10-01 | Plan funding arrangement – Insurance | Yes |
| 2014-10-01 | Plan benefit arrangement – Insurance | Yes |
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) | |||||||||||||||||||||||||||
| Policy contract number | 874927G | ||||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||||
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| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) | |||||||||||||||||||||||||||
| Policy contract number | 874927G | ||||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||||
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