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HIGH COUNTRY COMMUNITY HEALTH 401K PLAN 401k Plan overview

Plan NameHIGH COUNTRY COMMUNITY HEALTH 401K PLAN
Plan identification number 001

HIGH COUNTRY COMMUNITY HEALTH 401K PLAN Benefits

401k Plan TypeDefined Contribution Pension
Plan Features/Benefits
  • 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.
  • Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
  • 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.

401k Sponsoring company profile

HIGH COUNTRY COMMUNITY HEALTH INC. has sponsored the creation of one or more 401k plans.

Company Name:HIGH COUNTRY COMMUNITY HEALTH INC.
Employer identification number (EIN):273033445
NAIC Classification:541990
NAIC Description:All Other Professional, Scientific, and Technical Services

Form 5500 Filing Information

Submission information for form 5500 for 401k plan HIGH COUNTRY COMMUNITY HEALTH 401K PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012022-01-01
0012021-01-01ALICE SALTHOUSE2022-05-17 ALICE SALTHOUSE2022-05-17
0012020-01-01ALICE SALTHOUSE2021-03-04
0012019-01-01ALICE SALTHOUSE2020-04-15
0012018-01-01ALICE SALTHOUSE2019-04-09
0012017-01-01ALICE SALTHOUSE2018-05-04
0012016-01-01ALICE SALTHOUSE2017-05-24 STACEY HARRIS2017-05-09
0012015-01-01
0012014-01-01ALICE SALTHOUSE2015-11-18 ALICE SALTHOUSE2015-11-18
0012013-01-01ALICE SALTHOUSE2014-10-14 ALICE SALTHOUSE2014-10-14
0012012-01-01MARTY WILSON2013-10-03 MARTY WILSON2013-10-03

Plan Statistics for HIGH COUNTRY COMMUNITY HEALTH 401K PLAN

401k plan membership statisitcs for HIGH COUNTRY COMMUNITY HEALTH 401K PLAN

Measure Date Value
2022: HIGH COUNTRY COMMUNITY HEALTH 401K PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-01141
Total number of active participants reported on line 7a of the Form 55002022-01-01153
Number of retired or separated participants receiving benefits2022-01-013
Number of other retired or separated participants entitled to future benefits2022-01-0121
Total of all active and inactive participants2022-01-01177
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2022-01-010
Total participants2022-01-01177
Number of participants with account balances2022-01-0182
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2022-01-010

Financial Data on HIGH COUNTRY COMMUNITY HEALTH 401K PLAN

Measure Date Value
2022 : HIGH COUNTRY COMMUNITY HEALTH 401K PLAN 2022 401k financial data
Total unrealized appreciation/depreciation of assets2022-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$0
Total income from all sources (including contributions)2022-12-31$203,938
Total loss/gain on sale of assets2022-12-31$0
Total of all expenses incurred2022-12-31$52,993
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-12-31$47,275
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-12-31$448,191
Value of total assets at end of year2022-12-31$1,602,064
Value of total assets at beginning of year2022-12-31$1,451,119
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-12-31$5,718
Total interest from all sources2022-12-31$3,233
Total dividends received (eg from common stock, registered investment company shares)2022-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2022-12-31No
Was this plan covered by a fidelity bond2022-12-31Yes
Value of fidelity bond cover2022-12-31$160,116
If this is an individual account plan, was there a blackout period2022-12-31No
Were there any nonexempt tranactions with any party-in-interest2022-12-31No
Contributions received from participants2022-12-31$281,925
Participant contributions at end of year2022-12-31$53,578
Participant contributions at beginning of year2022-12-31$14,868
Income. Received or receivable in cash from other sources (including rollovers)2022-12-31$24,749
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$150,945
Value of net assets at end of year (total assets less liabilities)2022-12-31$1,602,064
Value of net assets at beginning of year (total assets less liabilities)2022-12-31$1,451,119
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 in pooled separate accounts at end of year2022-12-31$1,346,145
Value of interest in pooled separate accounts at beginning of year2022-12-31$1,328,815
Interest on participant loans2022-12-31$1,828
Interest earned on other investments2022-12-31$1,405
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2022-12-31$193,034
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2022-12-31$96,973
Net investment gain/loss from registered investment companies (e.g. mutual funds)2022-12-31$-247,486
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2022-12-31No
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$141,517
Employer contributions (assets) at end of year2022-12-31$9,307
Employer contributions (assets) at beginning of year2022-12-31$10,463
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2022-12-31$47,275
Contract administrator fees2022-12-31$5,718
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 name2022-12-31TERRY HORNE, CPA
Accountancy firm EIN2022-12-31621867889

Form 5500 Responses for HIGH COUNTRY COMMUNITY HEALTH 401K PLAN

2022: HIGH COUNTRY COMMUNITY HEALTH 401K PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle 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

Insurance Providers Used on plan

VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )
Policy contract number813134
Policy instance 1
Insurance contract or identification number813134
Number of Individuals Covered79
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $7,002
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
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?Yes
Health Insurance Welfare BenefitNo
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,002
Insurance broker organization code?3

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