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TRI COUNTY MENTAL HEALTH 401k Plan overview

Plan NameTRI COUNTY MENTAL HEALTH
Plan identification number 501

TRI COUNTY MENTAL HEALTH Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Vision
  • Long-term disability cover
  • Other welfare benefit cover
  • 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

TRI-COUNTY MENTAL HEALTH SERVICES, INC., DBA BEACON MENTAL HEALTH has sponsored the creation of one or more 401k plans.

Company Name:TRI-COUNTY MENTAL HEALTH SERVICES, INC., DBA BEACON MENTAL HEALTH
Employer identification number (EIN):431556416
NAIC Classification:621420
NAIC Description:Outpatient Mental Health and Substance Abuse Centers

Form 5500 Filing Information

Submission information for form 5500 for 401k plan TRI COUNTY MENTAL HEALTH

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012022-10-01
5012021-10-01
5012020-10-01CAROLYN WORTH2021-12-28
5012019-10-01CAROLYN WORTH2021-04-05
5012001-01-01CAROLYN WORTH2021-04-05

Plan Statistics for TRI COUNTY MENTAL HEALTH

401k plan membership statisitcs for TRI COUNTY MENTAL HEALTH

Measure Date Value
2022: TRI COUNTY MENTAL HEALTH 2022 401k membership
Total participants, beginning-of-year2022-10-01155
Total number of active participants reported on line 7a of the Form 55002022-10-01162
Number of retired or separated participants receiving benefits2022-10-010
Number of other retired or separated participants entitled to future benefits2022-10-010
Total of all active and inactive participants2022-10-01162
2021: TRI COUNTY MENTAL HEALTH 2021 401k membership
Total participants, beginning-of-year2021-10-01148
Total number of active participants reported on line 7a of the Form 55002021-10-01155
Number of retired or separated participants receiving benefits2021-10-010
Number of other retired or separated participants entitled to future benefits2021-10-010
Total of all active and inactive participants2021-10-01155
2020: TRI COUNTY MENTAL HEALTH 2020 401k membership
Total participants, beginning-of-year2020-10-01109
Total number of active participants reported on line 7a of the Form 55002020-10-01109
Number of retired or separated participants receiving benefits2020-10-010
Number of other retired or separated participants entitled to future benefits2020-10-010
Total of all active and inactive participants2020-10-01109
Number of employers contributing to the scheme2020-10-010
2019: TRI COUNTY MENTAL HEALTH 2019 401k membership
Total participants, beginning-of-year2019-10-0189
Total number of active participants reported on line 7a of the Form 55002019-10-01109
Number of retired or separated participants receiving benefits2019-10-010
Number of other retired or separated participants entitled to future benefits2019-10-010
Total of all active and inactive participants2019-10-01109
Number of employers contributing to the scheme2019-10-010
2001: TRI COUNTY MENTAL HEALTH 2001 401k membership
Total participants, beginning-of-year2001-01-0117
Total number of active participants reported on line 7a of the Form 55002001-01-0115
Number of retired or separated participants receiving benefits2001-01-010
Number of other retired or separated participants entitled to future benefits2001-01-010
Total of all active and inactive participants2001-01-0115
Number of employers contributing to the scheme2001-01-010

Form 5500 Responses for TRI COUNTY MENTAL HEALTH

2022: TRI COUNTY MENTAL HEALTH 2022 form 5500 responses
2022-10-01Type of plan entitySingle employer plan
2022-10-01Plan funding arrangement – InsuranceYes
2022-10-01Plan funding arrangement – General assets of the sponsorYes
2022-10-01Plan benefit arrangement – InsuranceYes
2022-10-01Plan benefit arrangement – General assets of the sponsorYes
2021: TRI COUNTY MENTAL HEALTH 2021 form 5500 responses
2021-10-01Type of plan entitySingle employer plan
2021-10-01Plan funding arrangement – InsuranceYes
2021-10-01Plan funding arrangement – General assets of the sponsorYes
2021-10-01Plan benefit arrangement – InsuranceYes
2021-10-01Plan benefit arrangement – General assets of the sponsorYes
2020: TRI COUNTY MENTAL HEALTH 2020 form 5500 responses
2020-10-01Type of plan entitySingle employer plan
2020-10-01Plan funding arrangement – General assets of the sponsorYes
2020-10-01Plan benefit arrangement – General assets of the sponsorYes
2019: TRI COUNTY MENTAL HEALTH 2019 form 5500 responses
2019-10-01Type of plan entitySingle employer plan
2019-10-01Plan funding arrangement – General assets of the sponsorYes
2019-10-01Plan benefit arrangement – General assets of the sponsorYes
2001: TRI COUNTY MENTAL HEALTH 2001 form 5500 responses
2001-01-01Type of plan entitySingle employer plan
2001-01-01Submission has been amendedYes
2001-01-01Plan funding arrangement – General assets of the sponsorYes
2001-01-01Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00565205
Policy instance 1
Insurance contract or identification number00565205
Number of Individuals Covered162
Insurance policy start date2022-10-01
Insurance policy end date2023-09-30
Total amount of commissions paid to insurance brokerUSD $11,586
Total amount of fees paid to insurance companyUSD $4,159
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $113,138
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $11,586
Amount paid for insurance broker fees4159
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00565205
Policy instance 1
Insurance contract or identification number00565205
Number of Individuals Covered141
Insurance policy start date2021-10-01
Insurance policy end date2022-09-30
Total amount of commissions paid to insurance brokerUSD $12,704
Total amount of fees paid to insurance companyUSD $5,437
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $122,177
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,109
Amount paid for insurance broker fees4976
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3

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