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CHESTNUT HILL MENTAL HEALTH CENTER, INC. DBA SPRINGBROOK BEHAVIOR HEALTH SYSTEM LIFE, DENTAL, VISION AND DISABILITY PLAN 401k Plan overview

Plan NameCHESTNUT HILL MENTAL HEALTH CENTER, INC. DBA SPRINGBROOK BEHAVIOR HEALTH SYSTEM LIFE, DENTAL, VISION AND DISABILITY PLAN
Plan identification number 501

CHESTNUT HILL MENTAL HEALTH CENTER, INC. DBA SPRINGBROOK BEHAVIOR HEALTH SYSTEM LIFE, DENTAL, VISION AND DISABILITY PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Life insurance
  • Dental
  • Vision
  • Temporary disability (accident and sickness)
  • Long-term disability cover
  • Death benefits (include travel accident but not life insurance)
  • Other welfare benefit cover

401k Sponsoring company profile

SPRINGBROOK BEHAVIORAL HEALTH SYSTE has sponsored the creation of one or more 401k plans.

Company Name:SPRINGBROOK BEHAVIORAL HEALTH SYSTE
Employer identification number (EIN):570693272
NAIC Classification:622000
NAIC Description: Hospitals

Form 5500 Filing Information

Submission information for form 5500 for 401k plan CHESTNUT HILL MENTAL HEALTH CENTER, INC. DBA SPRINGBROOK BEHAVIOR HEALTH SYSTEM LIFE, DENTAL, VISION AND DISABILITY PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012018-02-01BART BENNETT
5012017-02-01
5012016-02-01BART BENNETT
5012015-02-01BART BENNETT
5012014-02-01BART BENNETT
5012014-02-01BART BENNETT

Plan Statistics for CHESTNUT HILL MENTAL HEALTH CENTER, INC. DBA SPRINGBROOK BEHAVIOR HEALTH SYSTEM LIFE, DENTAL, VISION AND DISABILITY PLAN

401k plan membership statisitcs for CHESTNUT HILL MENTAL HEALTH CENTER, INC. DBA SPRINGBROOK BEHAVIOR HEALTH SYSTEM LIFE, DENTAL, VISION AND DISABILITY PLAN

Measure Date Value
2018: CHESTNUT HILL MENTAL HEALTH CENTER, INC. DBA SPRINGBROOK BEHAVIOR HEALTH SYSTEM LIFE, DENTAL, VISION AND DISABILITY PLAN 2018 401k membership
Total participants, beginning-of-year2018-02-01172
Total number of active participants reported on line 7a of the Form 55002018-02-010
Number of retired or separated participants receiving benefits2018-02-010
Number of other retired or separated participants entitled to future benefits2018-02-010
Total of all active and inactive participants2018-02-010
2017: CHESTNUT HILL MENTAL HEALTH CENTER, INC. DBA SPRINGBROOK BEHAVIOR HEALTH SYSTEM LIFE, DENTAL, VISION AND DISABILITY PLAN 2017 401k membership
Total participants, beginning-of-year2017-02-01171
Total number of active participants reported on line 7a of the Form 55002017-02-01172
Number of retired or separated participants receiving benefits2017-02-010
Number of other retired or separated participants entitled to future benefits2017-02-010
Total of all active and inactive participants2017-02-01172
2016: CHESTNUT HILL MENTAL HEALTH CENTER, INC. DBA SPRINGBROOK BEHAVIOR HEALTH SYSTEM LIFE, DENTAL, VISION AND DISABILITY PLAN 2016 401k membership
Total participants, beginning-of-year2016-02-01137
Total number of active participants reported on line 7a of the Form 55002016-02-01171
Number of retired or separated participants receiving benefits2016-02-010
Number of other retired or separated participants entitled to future benefits2016-02-010
Total of all active and inactive participants2016-02-01171
2015: CHESTNUT HILL MENTAL HEALTH CENTER, INC. DBA SPRINGBROOK BEHAVIOR HEALTH SYSTEM LIFE, DENTAL, VISION AND DISABILITY PLAN 2015 401k membership
Total participants, beginning-of-year2015-02-01130
Total number of active participants reported on line 7a of the Form 55002015-02-01137
Number of retired or separated participants receiving benefits2015-02-010
Number of other retired or separated participants entitled to future benefits2015-02-010
Total of all active and inactive participants2015-02-01137
2014: CHESTNUT HILL MENTAL HEALTH CENTER, INC. DBA SPRINGBROOK BEHAVIOR HEALTH SYSTEM LIFE, DENTAL, VISION AND DISABILITY PLAN 2014 401k membership
Total participants, beginning-of-year2014-02-01116
Total number of active participants reported on line 7a of the Form 55002014-02-01130
Number of retired or separated participants receiving benefits2014-02-010
Number of other retired or separated participants entitled to future benefits2014-02-010
Total of all active and inactive participants2014-02-01130

Form 5500 Responses for CHESTNUT HILL MENTAL HEALTH CENTER, INC. DBA SPRINGBROOK BEHAVIOR HEALTH SYSTEM LIFE, DENTAL, VISION AND DISABILITY PLAN

2018: CHESTNUT HILL MENTAL HEALTH CENTER, INC. DBA SPRINGBROOK BEHAVIOR HEALTH SYSTEM LIFE, DENTAL, VISION AND DISABILITY PLAN 2018 form 5500 responses
2018-02-01Type of plan entitySingle employer plan
2018-02-01Submission has been amendedNo
2018-02-01This submission is the final filingYes
2018-02-01This return/report is a short plan year return/report (less than 12 months)Yes
2018-02-01Plan is a collectively bargained planNo
2018-02-01Plan funding arrangement – InsuranceYes
2018-02-01Plan funding arrangement – General assets of the sponsorYes
2018-02-01Plan benefit arrangement – InsuranceYes
2018-02-01Plan benefit arrangement – General assets of the sponsorYes
2017: CHESTNUT HILL MENTAL HEALTH CENTER, INC. DBA SPRINGBROOK BEHAVIOR HEALTH SYSTEM LIFE, DENTAL, VISION AND DISABILITY PLAN 2017 form 5500 responses
2017-02-01Type of plan entitySingle employer plan
2017-02-01Plan funding arrangement – InsuranceYes
2017-02-01Plan benefit arrangement – InsuranceYes
2016: CHESTNUT HILL MENTAL HEALTH CENTER, INC. DBA SPRINGBROOK BEHAVIOR HEALTH SYSTEM LIFE, DENTAL, VISION AND DISABILITY PLAN 2016 form 5500 responses
2016-02-01Type of plan entitySingle employer plan
2016-02-01Submission has been amendedNo
2016-02-01This submission is the final filingNo
2016-02-01This return/report is a short plan year return/report (less than 12 months)No
2016-02-01Plan is a collectively bargained planNo
2016-02-01Plan funding arrangement – InsuranceYes
2016-02-01Plan benefit arrangement – InsuranceYes
2015: CHESTNUT HILL MENTAL HEALTH CENTER, INC. DBA SPRINGBROOK BEHAVIOR HEALTH SYSTEM LIFE, DENTAL, VISION AND DISABILITY PLAN 2015 form 5500 responses
2015-02-01Type of plan entitySingle employer plan
2015-02-01Submission has been amendedNo
2015-02-01This submission is the final filingNo
2015-02-01This return/report is a short plan year return/report (less than 12 months)No
2015-02-01Plan is a collectively bargained planNo
2015-02-01Plan funding arrangement – InsuranceYes
2015-02-01Plan benefit arrangement – InsuranceYes
2014: CHESTNUT HILL MENTAL HEALTH CENTER, INC. DBA SPRINGBROOK BEHAVIOR HEALTH SYSTEM LIFE, DENTAL, VISION AND DISABILITY PLAN 2014 form 5500 responses
2014-02-01Type of plan entitySingle employer plan
2014-02-01First time form 5500 has been submittedYes
2014-02-01Submission has been amendedYes
2014-02-01This submission is the final filingNo
2014-02-01This return/report is a short plan year return/report (less than 12 months)No
2014-02-01Plan is a collectively bargained planNo
2014-02-01Plan funding arrangement – InsuranceYes
2014-02-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00475339
Policy instance 1
Insurance contract or identification number00475339
Number of Individuals Covered213
Insurance policy start date2018-02-01
Insurance policy end date2018-08-31
Total amount of commissions paid to insurance brokerUSD $7,193
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?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedADD, OPTIONAL LIFE
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 $67,979
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,193
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 number475339
Policy instance 1
Insurance contract or identification number475339
Number of Individuals Covered172
Insurance policy start date2017-02-01
Insurance policy end date2017-08-31
Total amount of commissions paid to insurance brokerUSD $7,034
Total amount of fees paid to insurance companyUSD $5,542
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $63,856
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,255
Amount paid for insurance broker fees5542
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
Insurance broker nameASSUREDPARTNERS
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number475339
Policy instance 1
Insurance contract or identification number475339
Number of Individuals Covered137
Insurance policy start date2015-02-01
Insurance policy end date2016-01-31
Total amount of commissions paid to insurance brokerUSD $11,888
Total amount of fees paid to insurance companyUSD $5,084
Are there contracts with allocated funds for individual policies?No
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 BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
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 $113,301
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,494
Insurance broker organization code?3
Amount paid for insurance broker fees5084
Additional information about fees paid to insurance brokerFEES
Insurance broker nameUNKNOWN
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00475339
Policy instance 1
Insurance contract or identification number00475339
Number of Individuals Covered130
Insurance policy start date2014-02-01
Insurance policy end date2015-01-31
Total amount of commissions paid to insurance brokerUSD $10,013
Total amount of fees paid to insurance companyUSD $4,460
Are there contracts with allocated funds for individual policies?No
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 BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH & DISMEMERMENT
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 $95,649
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number475339
Policy instance 1
Insurance contract or identification number475339
Number of Individuals Covered130
Insurance policy start date2014-02-01
Insurance policy end date2015-01-31
Total amount of commissions paid to insurance brokerUSD $10,013
Total amount of fees paid to insurance companyUSD $4,460
Are there contracts with allocated funds for individual policies?No
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 BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
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 $95,649
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $10,013
Amount paid for insurance broker fees4460
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
Insurance broker nameBB AND T INSURANCE SERVICES, INC.

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