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COMMUNITY CARE AMBULANCE NETWORK HEALTH INSURANCE PLAN 401k Plan overview

Plan NameCOMMUNITY CARE AMBULANCE NETWORK HEALTH INSURANCE PLAN
Plan identification number 502

COMMUNITY CARE AMBULANCE NETWORK HEALTH INSURANCE PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Dental
  • Vision
  • Unfunded, fully insured, or combination unfunded/insured welfare plan that will not file a Form 5500 for next plan year pursuant to 29 CFR 2520.104-20.
  • Unfunded, fully insured, or combination unfunded/insured welfare plan that stopped filing form 5500s in an earlier plan year pursuant to 29 CFR 2520.104-20.

401k Sponsoring company profile

COMMUNITY CARE AMBULANCE NETWORK has sponsored the creation of one or more 401k plans.

Company Name:COMMUNITY CARE AMBULANCE NETWORK
Employer identification number (EIN):341766905
NAIC Classification:621900

Additional information about COMMUNITY CARE AMBULANCE NETWORK

Jurisdiction of Incorporation: Ohio Secretary of State Business Services Division
Incorporation Date: 1994-03-07
Company Identification Number: 866351
Legal Registered Office Address: 115 E 24TH ST
-
ASHTABULA
United States of America (USA)
440043417

More information about COMMUNITY CARE AMBULANCE NETWORK

Form 5500 Filing Information

Submission information for form 5500 for 401k plan COMMUNITY CARE AMBULANCE NETWORK HEALTH INSURANCE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5022019-07-01KIM EGELAND2021-04-11
5022018-07-01MICHAEL SASS2020-02-26
5022017-07-01JEFF LAMPSON
5022016-11-01JEFF LAMPSON
5022014-11-01JEFF LAMPSON

Plan Statistics for COMMUNITY CARE AMBULANCE NETWORK HEALTH INSURANCE PLAN

401k plan membership statisitcs for COMMUNITY CARE AMBULANCE NETWORK HEALTH INSURANCE PLAN

Measure Date Value
2019: COMMUNITY CARE AMBULANCE NETWORK HEALTH INSURANCE PLAN 2019 401k membership
Total participants, beginning-of-year2019-07-01103
Total number of active participants reported on line 7a of the Form 55002019-07-01102
Number of retired or separated participants receiving benefits2019-07-011
Total of all active and inactive participants2019-07-01103
2018: COMMUNITY CARE AMBULANCE NETWORK HEALTH INSURANCE PLAN 2018 401k membership
Total participants, beginning-of-year2018-07-01103
Total number of active participants reported on line 7a of the Form 55002018-07-0188
Number of retired or separated participants receiving benefits2018-07-010
Number of other retired or separated participants entitled to future benefits2018-07-010
Total of all active and inactive participants2018-07-0188
2017: COMMUNITY CARE AMBULANCE NETWORK HEALTH INSURANCE PLAN 2017 401k membership
Total participants, beginning-of-year2017-07-01108
Total number of active participants reported on line 7a of the Form 55002017-07-01103
Number of retired or separated participants receiving benefits2017-07-010
Number of other retired or separated participants entitled to future benefits2017-07-010
Total of all active and inactive participants2017-07-01103
2016: COMMUNITY CARE AMBULANCE NETWORK HEALTH INSURANCE PLAN 2016 401k membership
Total participants, beginning-of-year2016-11-01103
Total number of active participants reported on line 7a of the Form 55002016-11-01108
Number of retired or separated participants receiving benefits2016-11-010
Number of other retired or separated participants entitled to future benefits2016-11-010
Total of all active and inactive participants2016-11-01108
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2016-11-010
2014: COMMUNITY CARE AMBULANCE NETWORK HEALTH INSURANCE PLAN 2014 401k membership
Total participants, beginning-of-year2014-11-01100
Total number of active participants reported on line 7a of the Form 55002014-11-0199
Number of retired or separated participants receiving benefits2014-11-010
Number of other retired or separated participants entitled to future benefits2014-11-010
Total of all active and inactive participants2014-11-0199

Form 5500 Responses for COMMUNITY CARE AMBULANCE NETWORK HEALTH INSURANCE PLAN

2019: COMMUNITY CARE AMBULANCE NETWORK HEALTH INSURANCE PLAN 2019 form 5500 responses
2019-07-01Type of plan entitySingle employer plan
2019-07-01Submission has been amendedNo
2019-07-01This submission is the final filingNo
2019-07-01This return/report is a short plan year return/report (less than 12 months)No
2019-07-01Plan is a collectively bargained planYes
2019-07-01Plan funding arrangement – InsuranceYes
2019-07-01Plan funding arrangement – General assets of the sponsorYes
2019-07-01Plan benefit arrangement – InsuranceYes
2019-07-01Plan benefit arrangement – General assets of the sponsorYes
2018: COMMUNITY CARE AMBULANCE NETWORK HEALTH INSURANCE PLAN 2018 form 5500 responses
2018-07-01Type of plan entitySingle employer plan
2018-07-01Submission has been amendedNo
2018-07-01This submission is the final filingNo
2018-07-01This return/report is a short plan year return/report (less than 12 months)No
2018-07-01Plan is a collectively bargained planYes
2018-07-01Plan funding arrangement – InsuranceYes
2018-07-01Plan funding arrangement – General assets of the sponsorYes
2018-07-01Plan benefit arrangement – InsuranceYes
2018-07-01Plan benefit arrangement – General assets of the sponsorYes
2017: COMMUNITY CARE AMBULANCE NETWORK HEALTH INSURANCE PLAN 2017 form 5500 responses
2017-07-01Type of plan entitySingle employer plan
2017-07-01Submission has been amendedNo
2017-07-01This submission is the final filingNo
2017-07-01This return/report is a short plan year return/report (less than 12 months)No
2017-07-01Plan is a collectively bargained planNo
2017-07-01Plan funding arrangement – InsuranceYes
2017-07-01Plan funding arrangement – General assets of the sponsorYes
2017-07-01Plan benefit arrangement – InsuranceYes
2017-07-01Plan benefit arrangement – General assets of the sponsorYes
2016: COMMUNITY CARE AMBULANCE NETWORK HEALTH INSURANCE PLAN 2016 form 5500 responses
2016-11-01Type of plan entitySingle employer plan
2016-11-01Submission has been amendedNo
2016-11-01This submission is the final filingNo
2016-11-01This return/report is a short plan year return/report (less than 12 months)Yes
2016-11-01Plan is a collectively bargained planNo
2016-11-01Plan funding arrangement – InsuranceYes
2016-11-01Plan funding arrangement – General assets of the sponsorYes
2016-11-01Plan benefit arrangement – InsuranceYes
2016-11-01Plan benefit arrangement – General assets of the sponsorYes
2014: COMMUNITY CARE AMBULANCE NETWORK HEALTH INSURANCE PLAN 2014 form 5500 responses
2014-11-01Type of plan entitySingle employer plan
2014-11-01First time form 5500 has been submittedYes
2014-11-01Submission has been amendedNo
2014-11-01This submission is the final filingNo
2014-11-01This return/report is a short plan year return/report (less than 12 months)No
2014-11-01Plan is a collectively bargained planNo
2014-11-01Plan funding arrangement – InsuranceYes
2014-11-01Plan funding arrangement – General assets of the sponsorYes
2014-11-01Plan benefit arrangement – InsuranceYes
2014-11-01Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

COMMUNITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 10345 )
Policy contract number00249107
Policy instance 1
Insurance contract or identification number00249107
Number of Individuals Covered193
Insurance policy start date2019-07-01
Insurance policy end date2020-06-30
Total amount of commissions paid to insurance brokerUSD $32,892
Total amount of fees paid to insurance companyUSD $19,411
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?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 $1,122,373
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $31,085
Amount paid for insurance broker fees19411
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
COMMUNITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 10345 )
Policy contract number00249107
Policy instance 1
Insurance contract or identification number00249107
Number of Individuals Covered192
Insurance policy start date2018-07-01
Insurance policy end date2019-06-30
Total amount of commissions paid to insurance brokerUSD $39,791
Total amount of fees paid to insurance companyUSD $6,960
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?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 $1,048,191
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $31,134
Amount paid for insurance broker fees6960
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
COMMUNITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 10345 )
Policy contract number00249107
Policy instance 1
Insurance contract or identification number00249107
Number of Individuals Covered207
Insurance policy start date2017-07-01
Insurance policy end date2018-06-30
Total amount of commissions paid to insurance brokerUSD $52,480
Total amount of fees paid to insurance companyUSD $3,006
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?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 $1,098,705
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $52,480
Amount paid for insurance broker fees3006
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
Insurance broker nameTHE JAMES B OSWALD COMPANY

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