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SOUTHWEST KANSAS CHAMBERS ALLIANCE HEALTH PLAN, INC. 401k Plan overview

Plan NameSOUTHWEST KANSAS CHAMBERS ALLIANCE HEALTH PLAN, INC.
Plan identification number 501

SOUTHWEST KANSAS CHAMBERS ALLIANCE HEALTH PLAN, INC. Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Dental
  • Vision

401k Sponsoring company profile

SOUTHWEST KANSAS CHAMBERS ALLIANCE has sponsored the creation of one or more 401k plans.

Company Name:SOUTHWEST KANSAS CHAMBERS ALLIANCE
Employer identification number (EIN):851809543
NAIC Classification:813000
NAIC Description: Religious, Grantmaking, Civic, Professional, and Similar Organizations

Form 5500 Filing Information

Submission information for form 5500 for 401k plan SOUTHWEST KANSAS CHAMBERS ALLIANCE HEALTH PLAN, INC.

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012022-01-01LINDSAY SINGLEY2023-10-14
5012021-01-01LINDSAY SINGLEY2022-12-23
5012020-01-01

Plan Statistics for SOUTHWEST KANSAS CHAMBERS ALLIANCE HEALTH PLAN, INC.

401k plan membership statisitcs for SOUTHWEST KANSAS CHAMBERS ALLIANCE HEALTH PLAN, INC.

Measure Date Value
2022: SOUTHWEST KANSAS CHAMBERS ALLIANCE HEALTH PLAN, INC. 2022 401k membership
Total participants, beginning-of-year2022-01-01383
Total number of active participants reported on line 7a of the Form 55002022-01-01355
Number of retired or separated participants receiving benefits2022-01-018
Number of other retired or separated participants entitled to future benefits2022-01-0199
Total of all active and inactive participants2022-01-01462
2021: SOUTHWEST KANSAS CHAMBERS ALLIANCE HEALTH PLAN, INC. 2021 401k membership
Total participants, beginning-of-year2021-01-01567
Total number of active participants reported on line 7a of the Form 55002021-01-01577
Number of retired or separated participants receiving benefits2021-01-018
Number of other retired or separated participants entitled to future benefits2021-01-0117
Total of all active and inactive participants2021-01-01602
2020: SOUTHWEST KANSAS CHAMBERS ALLIANCE HEALTH PLAN, INC. 2020 401k membership
Total participants, beginning-of-year2020-01-01484
Total number of active participants reported on line 7a of the Form 55002020-01-01524
Number of retired or separated participants receiving benefits2020-01-010
Number of other retired or separated participants entitled to future benefits2020-01-010
Total of all active and inactive participants2020-01-01524

Financial Data on SOUTHWEST KANSAS CHAMBERS ALLIANCE HEALTH PLAN, INC.

Measure Date Value
2022 : SOUTHWEST KANSAS CHAMBERS ALLIANCE HEALTH PLAN, INC. 2022 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$409,634
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$986,144
Total income from all sources (including contributions)2022-12-31$2,992,770
Total of all expenses incurred2022-12-31$2,514,573
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-12-31$2,211,409
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-12-31$2,992,743
Value of total assets at end of year2022-12-31$13,872
Value of total assets at beginning of year2022-12-31$112,185
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-12-31$303,164
Total interest from all sources2022-12-31$27
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2022-12-31No
Administrative expenses professional fees incurred2022-12-31$80,706
Was this plan covered by a fidelity bond2022-12-31Yes
Value of fidelity bond cover2022-12-31$1,000,000
Were there any nonexempt tranactions with any party-in-interest2022-12-31Yes
Amount of non-exempt transactions with any party-in-interest2022-12-31$2,000
Contributions received from participants2022-12-31$517,461
Income. Received or receivable in cash from other sources (including rollovers)2022-12-31$139,326
Total non interest bearing cash at end of year2022-12-31$13,121
Total non interest bearing cash at beginning of year2022-12-31$86,694
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Value of net income/loss2022-12-31$478,197
Value of net assets at end of year (total assets less liabilities)2022-12-31$-395,762
Value of net assets at beginning of year (total assets less liabilities)2022-12-31$-873,959
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2022-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2022-12-31No
Were any leases to which the plan was party in default or uncollectible2022-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2022-12-31$751
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2022-12-31$25,491
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2022-12-31$25,491
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2022-12-31$27
Expenses. Payments to insurance carriers foe the provision of benefits2022-12-31$328,105
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2022-12-31Yes
Was there a failure to transmit to the plan any participant contributions2022-12-31No
Has the plan failed to provide any benefit when due under the plan2022-12-31No
Contributions received in cash from employer2022-12-31$2,335,956
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2022-12-31$1,883,304
Contract administrator fees2022-12-31$222,458
Liabilities. Value of benefit claims payable at end of year2022-12-31$409,634
Liabilities. Value of benefit claims payable at beginning of year2022-12-31$986,144
Did the plan have assets held for investment2022-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2022-12-31No
Opinion of an independent qualified public accountant for this plan2022-12-31Unqualified
Accountancy firm name2022-12-31FORVIS, LLP
Accountancy firm EIN2022-12-31440160260
2021 : SOUTHWEST KANSAS CHAMBERS ALLIANCE HEALTH PLAN, INC. 2021 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$1,373,851
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$999,195
Total income from all sources (including contributions)2021-12-31$3,890,306
Total of all expenses incurred2021-12-31$4,560,827
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-12-31$4,305,542
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-12-31$3,890,211
Value of total assets at end of year2021-12-31$112,185
Value of total assets at beginning of year2021-12-31$408,050
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-12-31$255,285
Total interest from all sources2021-12-31$95
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2021-12-31No
Administrative expenses professional fees incurred2021-12-31$5,990
Was this plan covered by a fidelity bond2021-12-31Yes
Value of fidelity bond cover2021-12-31$1,000,000
Were there any nonexempt tranactions with any party-in-interest2021-12-31No
Contributions received from participants2021-12-31$759,712
Administrative expenses (other) incurred2021-12-31$39,930
Total non interest bearing cash at end of year2021-12-31$86,694
Total non interest bearing cash at beginning of year2021-12-31$307,901
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Value of net income/loss2021-12-31$-670,521
Value of net assets at end of year (total assets less liabilities)2021-12-31$-1,261,666
Value of net assets at beginning of year (total assets less liabilities)2021-12-31$-591,145
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2021-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2021-12-31No
Were any leases to which the plan was party in default or uncollectible2021-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2021-12-31$25,491
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2021-12-31$100,149
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2021-12-31$100,149
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2021-12-31$95
Expenses. Payments to insurance carriers foe the provision of benefits2021-12-31$461,733
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2021-12-31No
Was there a failure to transmit to the plan any participant contributions2021-12-31No
Has the plan failed to provide any benefit when due under the plan2021-12-31No
Contributions received in cash from employer2021-12-31$3,130,499
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2021-12-31$3,843,809
Contract administrator fees2021-12-31$209,365
Liabilities. Value of benefit claims payable at end of year2021-12-31$1,373,851
Liabilities. Value of benefit claims payable at beginning of year2021-12-31$999,195
Did the plan have assets held for investment2021-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2021-12-31No
Opinion of an independent qualified public accountant for this plan2021-12-31Unqualified
Accountancy firm name2021-12-31FORVIS, LLP
Accountancy firm EIN2021-12-31440160260
2020 : SOUTHWEST KANSAS CHAMBERS ALLIANCE HEALTH PLAN, INC. 2020 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$999,195
Total income from all sources (including contributions)2020-12-31$3,413,659
Total of all expenses incurred2020-12-31$4,004,804
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-12-31$3,750,547
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-12-31$3,413,510
Value of total assets at end of year2020-12-31$408,050
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-12-31$254,257
Total interest from all sources2020-12-31$149
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2020-12-31No
Administrative expenses professional fees incurred2020-12-31$5,561
Was this plan covered by a fidelity bond2020-12-31Yes
Value of fidelity bond cover2020-12-31$1,000,000
Were there any nonexempt tranactions with any party-in-interest2020-12-31No
Contributions received from participants2020-12-31$682,035
Administrative expenses (other) incurred2020-12-31$37,476
Total non interest bearing cash at end of year2020-12-31$307,901
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Value of net income/loss2020-12-31$-591,145
Value of net assets at end of year (total assets less liabilities)2020-12-31$-591,145
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2020-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2020-12-31No
Were any leases to which the plan was party in default or uncollectible2020-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2020-12-31$100,149
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2020-12-31$149
Expenses. Payments to insurance carriers foe the provision of benefits2020-12-31$325,364
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2020-12-31No
Was there a failure to transmit to the plan any participant contributions2020-12-31No
Has the plan failed to provide any benefit when due under the plan2020-12-31No
Contributions received in cash from employer2020-12-31$2,731,475
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2020-12-31$3,425,183
Contract administrator fees2020-12-31$211,220
Liabilities. Value of benefit claims payable at end of year2020-12-31$999,195
Did the plan have assets held for investment2020-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2020-12-31No
Opinion of an independent qualified public accountant for this plan2020-12-31Unqualified
Accountancy firm name2020-12-31FORVIS, LLP
Accountancy firm EIN2020-12-31440160260

Form 5500 Responses for SOUTHWEST KANSAS CHAMBERS ALLIANCE HEALTH PLAN, INC.

2022: SOUTHWEST KANSAS CHAMBERS ALLIANCE HEALTH PLAN, INC. 2022 form 5500 responses
2022-01-01Type of plan entityMulitple employer plan
2022-01-01Submission has been amendedNo
2022-01-01This submission is the final filingNo
2022-01-01This return/report is a short plan year return/report (less than 12 months)No
2022-01-01Plan is a collectively bargained planNo
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan funding arrangement – TrustYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement - TrustYes
2021: SOUTHWEST KANSAS CHAMBERS ALLIANCE HEALTH PLAN, INC. 2021 form 5500 responses
2021-01-01Type of plan entityMulitple employer plan
2021-01-01Submission has been amendedYes
2021-01-01This submission is the final filingNo
2021-01-01This return/report is a short plan year return/report (less than 12 months)No
2021-01-01Plan is a collectively bargained planNo
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan funding arrangement – TrustYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement - TrustYes
2020: SOUTHWEST KANSAS CHAMBERS ALLIANCE HEALTH PLAN, INC. 2020 form 5500 responses
2020-01-01Type of plan entityMulitple employer plan
2020-01-01First time form 5500 has been submittedYes
2020-01-01Submission has been amendedNo
2020-01-01This submission is the final filingNo
2020-01-01This return/report is a short plan year return/report (less than 12 months)No
2020-01-01Plan is a collectively bargained planNo
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan funding arrangement – TrustYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

WESTERN SKIES MGU LLC (National Association of Insurance Commissioners NAIC id number: 99999 )
Policy contract numberBIC-SL-0005
Policy instance 1
Insurance contract or identification numberBIC-SL-0005
Number of Individuals Covered462
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $328,105
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
WESTERN SKIES MGU LLC (National Association of Insurance Commissioners NAIC id number: 99999 )
Policy contract numberBIC-SL-0005
Policy instance 1
Insurance contract or identification numberBIC-SL-0005
Number of Individuals Covered602
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $461,733
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AMERICAN NATIONAL INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60739 )
Policy contract number99999
Policy instance 1
Insurance contract or identification number99999
Number of Individuals Covered524
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $325,364
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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