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PROFESSIONAL CASE MANAGEMENT HEALTH AND WELFARE PLAN 401k Plan overview

Plan NamePROFESSIONAL CASE MANAGEMENT HEALTH AND WELFARE PLAN
Plan identification number 501

PROFESSIONAL CASE MANAGEMENT HEALTH AND WELFARE PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Vision
  • Temporary disability (accident and sickness)
  • Prepaid legal
  • Long-term disability cover

401k Sponsoring company profile

ACT FOR HEALTH DBA PROFESSIONAL CASE MANAGEMENT has sponsored the creation of one or more 401k plans.

Company Name:ACT FOR HEALTH DBA PROFESSIONAL CASE MANAGEMENT
Employer identification number (EIN):841383042
NAIC Classification:621610
NAIC Description:Home Health Care Services

Form 5500 Filing Information

Submission information for form 5500 for 401k plan PROFESSIONAL CASE MANAGEMENT HEALTH AND WELFARE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012022-01-01BRAD DREVNO2023-09-06
5012021-01-01BRAD DREVNO2022-06-21
5012020-01-01JENNIFER HOFFMAN2021-06-01
5012020-01-01COURTNEY FARLEY2021-06-01
5012019-01-01BRAD DREVNO2020-05-08
5012018-01-01
5012017-01-01
5012016-01-01CASS OHNSTAD
5012015-01-01CASSANDRA OHNSTAD

Plan Statistics for PROFESSIONAL CASE MANAGEMENT HEALTH AND WELFARE PLAN

401k plan membership statisitcs for PROFESSIONAL CASE MANAGEMENT HEALTH AND WELFARE PLAN

Measure Date Value
2022: PROFESSIONAL CASE MANAGEMENT HEALTH AND WELFARE PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-01542
Total number of active participants reported on line 7a of the Form 55002022-01-01453
Number of retired or separated participants receiving benefits2022-01-014
Number of other retired or separated participants entitled to future benefits2022-01-0138
Total of all active and inactive participants2022-01-01495
Number of employers contributing to the scheme2022-01-010
2021: PROFESSIONAL CASE MANAGEMENT HEALTH AND WELFARE PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-01571
Total number of active participants reported on line 7a of the Form 55002021-01-01529
Number of retired or separated participants receiving benefits2021-01-013
Number of other retired or separated participants entitled to future benefits2021-01-0110
Total of all active and inactive participants2021-01-01542
Number of employers contributing to the scheme2021-01-010
2020: PROFESSIONAL CASE MANAGEMENT HEALTH AND WELFARE PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-01475
Total number of active participants reported on line 7a of the Form 55002020-01-01532
Number of retired or separated participants receiving benefits2020-01-013
Number of other retired or separated participants entitled to future benefits2020-01-01124
Total of all active and inactive participants2020-01-01659
Number of employers contributing to the scheme2020-01-010
2019: PROFESSIONAL CASE MANAGEMENT HEALTH AND WELFARE PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-01445
Total number of active participants reported on line 7a of the Form 55002019-01-01460
Number of retired or separated participants receiving benefits2019-01-013
Number of other retired or separated participants entitled to future benefits2019-01-0119
Total of all active and inactive participants2019-01-01482
Number of employers contributing to the scheme2019-01-010
2018: PROFESSIONAL CASE MANAGEMENT HEALTH AND WELFARE PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-01524
Total number of active participants reported on line 7a of the Form 55002018-01-01423
Number of retired or separated participants receiving benefits2018-01-012
Number of other retired or separated participants entitled to future benefits2018-01-0111
Total of all active and inactive participants2018-01-01436
Number of employers contributing to the scheme2018-01-010
2017: PROFESSIONAL CASE MANAGEMENT HEALTH AND WELFARE PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-01353
Total number of active participants reported on line 7a of the Form 55002017-01-01370
Number of retired or separated participants receiving benefits2017-01-016
Number of other retired or separated participants entitled to future benefits2017-01-0113
Total of all active and inactive participants2017-01-01389
2016: PROFESSIONAL CASE MANAGEMENT HEALTH AND WELFARE PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-01214
Total number of active participants reported on line 7a of the Form 55002016-01-01277
Number of retired or separated participants receiving benefits2016-01-013
Number of other retired or separated participants entitled to future benefits2016-01-0114
Total of all active and inactive participants2016-01-01294
2015: PROFESSIONAL CASE MANAGEMENT HEALTH AND WELFARE PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-01165
Total number of active participants reported on line 7a of the Form 55002015-01-01178
Number of retired or separated participants receiving benefits2015-01-012
Number of other retired or separated participants entitled to future benefits2015-01-0114
Total of all active and inactive participants2015-01-01194

Form 5500 Responses for PROFESSIONAL CASE MANAGEMENT HEALTH AND WELFARE PLAN

2022: PROFESSIONAL CASE MANAGEMENT HEALTH AND WELFARE 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: PROFESSIONAL CASE MANAGEMENT HEALTH AND WELFARE PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan benefit arrangement – InsuranceYes
2020: PROFESSIONAL CASE MANAGEMENT HEALTH AND WELFARE PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Submission has been amendedYes
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan benefit arrangement – InsuranceYes
2019: PROFESSIONAL CASE MANAGEMENT HEALTH AND WELFARE PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan benefit arrangement – InsuranceYes
2018: PROFESSIONAL CASE MANAGEMENT HEALTH AND WELFARE PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan benefit arrangement – InsuranceYes
2017: PROFESSIONAL CASE MANAGEMENT HEALTH AND WELFARE PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan benefit arrangement – InsuranceYes
2016: PROFESSIONAL CASE MANAGEMENT HEALTH AND WELFARE 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 benefit arrangement – InsuranceYes
2015: PROFESSIONAL CASE MANAGEMENT HEALTH AND WELFARE PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01First time form 5500 has been submittedYes
2015-01-01Submission has been amendedNo
2015-01-01This submission is the final filingNo
2015-01-01This return/report is a short plan year return/report (less than 12 months)No
2015-01-01Plan is a collectively bargained planNo
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number922579
Policy instance 3
Insurance contract or identification number922579
Number of Individuals Covered441
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $10,332
Total amount of fees paid to insurance companyUSD $3,588
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $161,958
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,323
Amount paid for insurance broker fees3588
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 )
Policy contract numberE3679016
Policy instance 2
Insurance contract or identification numberE3679016
Number of Individuals Covered35
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $9,483
Total amount of fees paid to insurance companyUSD $1,165
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENT, CRITICAL ILLNESS, HOSPITAL, CANCER
Welfare Benefit Premiums Paid to CarrierUSD $50,281
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,056
Amount paid for insurance broker fees0
Insurance broker organization code?3
Additional information about fees paid to insurance brokerFEES
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number925569
Policy instance 1
Insurance contract or identification number925569
Number of Individuals Covered997
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $99,897
Total amount of fees paid to insurance companyUSD $16,139
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $5,362,824
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $99,897
Amount paid for insurance broker fees16139
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
ROCKY MOUNTAIN HOSPITAL AND MEDICAL SERVICE, INC. (National Association of Insurance Commissioners NAIC id number: 11011 )
Policy contract number196122
Policy instance 1
Insurance contract or identification number196122
Number of Individuals Covered748
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $133,873
Total amount of fees paid to insurance companyUSD $2,214
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $6,138,446
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $133,873
Amount paid for insurance broker fees2214
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
ROCKY MOUNTAIN HOSPITAL AND MEDICAL SERVICE, INC. (National Association of Insurance Commissioners NAIC id number: 11011 )
Policy contract number196122
Policy instance 1
Insurance contract or identification number196122
Number of Individuals Covered785
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $97,406
Total amount of fees paid to insurance companyUSD $4,341
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,794,108
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $97,406
Amount paid for insurance broker fees4341
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
ANTHEM BLUE CROSS AND BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 95473 )
Policy contract number196122
Policy instance 2
Insurance contract or identification number196122
Number of Individuals Covered460
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $41
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,510
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $41
Amount paid for insurance broker fees0
Insurance broker organization code?3
ROCKY MOUNTAIN HOSPITAL AND MEDICAL SERVICE, INC. (National Association of Insurance Commissioners NAIC id number: 11011 )
Policy contract number196122
Policy instance 1
Insurance contract or identification number196122
Number of Individuals Covered635
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $114,574
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $4,217,254
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $114,574
Amount paid for insurance broker fees0
Insurance broker organization code?3
ANTHEM BLUE CROSS AND BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 95473 )
Policy contract number196122
Policy instance 2
Insurance contract or identification number196122
Number of Individuals Covered2
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $1,399
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $34,886
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $859
Amount paid for insurance broker fees0
Insurance broker organization code?3
ROCKY MOUNTAIN HOSPITAL AND MEDICAL SERVICE, INC. (National Association of Insurance Commissioners NAIC id number: 11011 )
Policy contract number196122
Policy instance 1
Insurance contract or identification number196122
Number of Individuals Covered556
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $123,207
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,072,484
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $75,630
Amount paid for insurance broker fees0
Insurance broker organization code?3
ROCKY MOUNTAIN HOSPITAL AND MEDICAL SERVICE, INC. (National Association of Insurance Commissioners NAIC id number: 11011 )
Policy contract number196122
Policy instance 2
Insurance contract or identification number196122
Number of Individuals Covered514
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $118,662
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,283,452
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $118,662
Amount paid for insurance broker fees0
Insurance broker organization code?3
Insurance broker nameLOCKTON COMPANIES, LLC
ANTHEM BLUE CROSS AND BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 95473 )
Policy contract number196122
Policy instance 1
Insurance contract or identification number196122
Number of Individuals Covered3
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $2,340
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $45,032
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,340
Amount paid for insurance broker fees0
Insurance broker organization code?3
Insurance broker nameLOCKTON COMPANIES, LLC
ROCKY MOUNTAIN HOSPITAL AND MEDICAL SERVICE, INC. (National Association of Insurance Commissioners NAIC id number: 11011 )
Policy contract number196122
Policy instance 2
Insurance contract or identification number196122
Number of Individuals Covered209
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $52,682
Total amount of fees paid to insurance companyUSD $1,218
Are there contracts with allocated funds for individual policies?No
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 BenefitYes
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 $1,254,484
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $52,682
Amount paid for insurance broker fees1218
Additional information about fees paid to insurance brokerBONUS OVERRIDE NON-MONETARY COMPENSATION
Insurance broker organization code?3
Insurance broker nameLOCKTON COMPANIES, LLC
ANTHEM BLUE CROSS AND BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 95473 )
Policy contract number196122
Policy instance 1
Insurance contract or identification number196122
Number of Individuals Covered4
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $1,218
Total amount of fees paid to insurance companyUSD $6
Are there contracts with allocated funds for individual policies?No
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 BenefitYes
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 $28,977
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,218
Amount paid for insurance broker fees6
Additional information about fees paid to insurance brokerBONUS OVERRIDE NON-MONETARY COMPENSATION
Insurance broker organization code?3
Insurance broker nameLOCKTON COMPANIES, LLC

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