401k Plan data: CCS HEALTHCARE BENEFIT PLAN plan

CCS HEALTHCARE BENEFIT PLAN 401k Plan overview

Plan Name	CCS HEALTHCARE BENEFIT PLAN
Plan identification number	501

CCS HEALTHCARE BENEFIT PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) Life insurance Supplemental unemployment Dental Vision Temporary disability (accident and sickness) Long-term disability cover

401k Sponsoring company profile

COMPREHENSIVE CANCER SERVICES ONCOLOGY, P.C. has sponsored the creation of one or more 401k plans.

Company Name: COMPREHENSIVE CANCER SERVICES ONCOLOGY, P.C.

Employer identification number (EIN): 991151000

NAIC Classification: 621399
NAIC Description: Offices of All Other Miscellaneous Health Practitioners

Additional information about COMPREHENSIVE CANCER SERVICES ONCOLOGY, P.C.

Jurisdiction of Incorporation: New York Department of State

Incorporation Date: 2008-06-30

Company Identification Number: 3691095

Legal Registered Office Address: 45 SPINDRIFT DRIVE, SUITE 102
Niagara
WILLIAMSVILLE
United States of America (USA)
14221

More information about COMPREHENSIVE CANCER SERVICES ONCOLOGY, P.C.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan CCS HEALTHCARE BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2016-01-01
501 2015-01-01

Plan Statistics for CCS HEALTHCARE BENEFIT PLAN

401k plan membership statisitcs for CCS HEALTHCARE BENEFIT PLAN

Measure Date Value
2016: CCS HEALTHCARE BENEFIT PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 151
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 180
Number of retired or separated participants receiving benefits 2016-01-01 2
Total of all active and inactive participants 2016-01-01 182
2015: CCS HEALTHCARE BENEFIT PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 217
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 267
Total of all active and inactive participants 2015-01-01 267

Measure	Date	Value
2016: CCS HEALTHCARE BENEFIT PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	151
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	180
Number of retired or separated participants receiving benefits	2016-01-01	2
Total of all active and inactive participants	2016-01-01	182
2015: CCS HEALTHCARE BENEFIT PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	217
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	267
Total of all active and inactive participants	2015-01-01	267

Form 5500 Responses for CCS HEALTHCARE BENEFIT PLAN

2016: CCS HEALTHCARE BENEFIT PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Plan funding arrangement – Insurance	Yes
2016-01-01	Plan benefit arrangement – Insurance	Yes
2015: CCS HEALTHCARE BENEFIT PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	First time form 5500 has been submitted	Yes
2015-01-01	Plan funding arrangement – Insurance	Yes
2015-01-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )

Policy contract number

767755G

Policy instance

Insurance contract or identification number	767755G
Number of Individuals Covered	236
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $10,140
Total amount of fees paid to insurance company	USD $862
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Unemployment Insurance Welfare Benefit	Yes
Other welfare benefits provided	AD&D
Welfare Benefit Premiums Paid to Carrier	USD $101,404
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $10,140
Amount paid for insurance broker fees	862
Additional information about fees paid to insurance broker	FEES
Insurance broker organization code?	3
Insurance broker name	EMS FINANCIAL SERVICES LLC

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )

Policy contract number

00748472

Policy instance

Insurance contract or identification number	00748472
Number of Individuals Covered	151
Insurance policy start date	2014-09-01
Insurance policy end date	2015-08-31
Total amount of commissions paid to insurance broker	USD $4,623
Total amount of fees paid to insurance company	USD $3,354
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $113,817
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $4,585
Amount paid for insurance broker fees	3354
Additional information about fees paid to insurance broker	SERVICE FEES
Insurance broker organization code?	3
Insurance broker name	ALLIANCE ADVISORY GRP INC

INDEPENDENT HEALTH (National Association of Insurance Commissioners NAIC id number: 47034 )

Policy contract number

21301

Policy instance

Insurance contract or identification number	21301
Number of Individuals Covered	267
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $39,957
Total amount of fees paid to insurance company	USD $0
Health Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $39,957
Insurance broker organization code?	3
Insurance broker name	EMS FINANCIAL SERVICES LLC

Potentially related plans

CCS HEALTHCARE 401(K) PROFIT SHARING PLAN [EIN = 474988194]

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Company Name:	COMPREHENSIVE CANCER SERVICES ONCOLOGY, P.C.
Employer identification number (EIN):	991151000
NAIC Classification:	621399
NAIC Description:	Offices of All Other Miscellaneous Health Practitioners

Jurisdiction of Incorporation:	New York Department of State
Incorporation Date:	2008-06-30
Company Identification Number:	3691095
Legal Registered Office Address:	45 SPINDRIFT DRIVE, SUITE 102 Niagara WILLIAMSVILLE United States of America (USA) 14221