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COMMUNITY HEALTH CONNECTIONS DENTAL PLAN 401k Plan overview

Plan NameCOMMUNITY HEALTH CONNECTIONS DENTAL PLAN
Plan identification number 502

COMMUNITY HEALTH CONNECTIONS DENTAL PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Dental
  • 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.

401k Sponsoring company profile

COMMUNITY HEALTH CONNECTIONS has sponsored the creation of one or more 401k plans.

Company Name:COMMUNITY HEALTH CONNECTIONS
Employer identification number (EIN):043452697
NAIC Classification:621498
NAIC Description:All Other Outpatient Care Centers

Additional information about COMMUNITY HEALTH CONNECTIONS

Jurisdiction of Incorporation: Nevada Department of State
Incorporation Date: 2009-03-09
Company Identification Number: 20091323732
Legal Registered Office Address: 400 S 4TH ST STE 270

LAS VEGAS
United States of America (USA)
89101

More information about COMMUNITY HEALTH CONNECTIONS

Form 5500 Filing Information

Submission information for form 5500 for 401k plan COMMUNITY HEALTH CONNECTIONS DENTAL PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5022017-01-01SARAH JOHNSON
5022016-01-01SARAH JOHNSON SARAH JOHNSON2017-08-21
5022015-01-01SARAH JOHNSON
5022014-01-01SARAH JOHNSON
5022013-01-01SARAH JOHNSON
5022012-01-01SARAH JOHNSON

Plan Statistics for COMMUNITY HEALTH CONNECTIONS DENTAL PLAN

401k plan membership statisitcs for COMMUNITY HEALTH CONNECTIONS DENTAL PLAN

Measure Date Value
2017: COMMUNITY HEALTH CONNECTIONS DENTAL PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-0154
Total number of active participants reported on line 7a of the Form 55002017-01-0158
Number of retired or separated participants receiving benefits2017-01-011
Total of all active and inactive participants2017-01-0159
Total participants2017-01-0159
2016: COMMUNITY HEALTH CONNECTIONS DENTAL PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-0150
Total number of active participants reported on line 7a of the Form 55002016-01-0151
Number of retired or separated participants receiving benefits2016-01-011
Total of all active and inactive participants2016-01-0152
Total participants2016-01-0152
2015: COMMUNITY HEALTH CONNECTIONS DENTAL PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-0161
Total number of active participants reported on line 7a of the Form 55002015-01-0150
Total of all active and inactive participants2015-01-0150
Total participants2015-01-0150
2014: COMMUNITY HEALTH CONNECTIONS DENTAL PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-0168
Total number of active participants reported on line 7a of the Form 55002014-01-0161
Total of all active and inactive participants2014-01-0161
Total participants2014-01-0161
2013: COMMUNITY HEALTH CONNECTIONS DENTAL PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-01156
Total number of active participants reported on line 7a of the Form 55002013-01-01151
Total of all active and inactive participants2013-01-01151
Total participants2013-01-01151
2012: COMMUNITY HEALTH CONNECTIONS DENTAL PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-01166
Total number of active participants reported on line 7a of the Form 55002012-01-01156
Total of all active and inactive participants2012-01-01156
Total participants2012-01-01156

Form 5500 Responses for COMMUNITY HEALTH CONNECTIONS DENTAL PLAN

2017: COMMUNITY HEALTH CONNECTIONS DENTAL PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Submission has been amendedNo
2017-01-01This submission is the final filingNo
2017-01-01This return/report is a short plan year return/report (less than 12 months)No
2017-01-01Plan is a collectively bargained planNo
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan benefit arrangement – InsuranceYes
2016: COMMUNITY HEALTH CONNECTIONS DENTAL PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Submission has been amendedNo
2016-01-01This submission is the final filingNo
2016-01-01This return/report is a short plan year return/report (less than 12 months)No
2016-01-01Plan is a collectively bargained planNo
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan benefit arrangement – InsuranceYes
2015: COMMUNITY HEALTH CONNECTIONS DENTAL PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01First time form 5500 has been submittedYes
2015-01-01Submission has been amendedNo
2015-01-01This submission is the final filingNo
2015-01-01This return/report is a short plan year return/report (less than 12 months)No
2015-01-01Plan is a collectively bargained planNo
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan benefit arrangement – InsuranceYes
2014: COMMUNITY HEALTH CONNECTIONS DENTAL PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01First time form 5500 has been submittedYes
2014-01-01Submission has been amendedNo
2014-01-01This submission is the final filingNo
2014-01-01This return/report is a short plan year return/report (less than 12 months)No
2014-01-01Plan is a collectively bargained planNo
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan benefit arrangement – InsuranceYes
2013: COMMUNITY HEALTH CONNECTIONS DENTAL PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01First time form 5500 has been submittedYes
2013-01-01Submission has been amendedNo
2013-01-01This submission is the final filingNo
2013-01-01This return/report is a short plan year return/report (less than 12 months)No
2013-01-01Plan is a collectively bargained planNo
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan benefit arrangement – InsuranceYes
2012: COMMUNITY HEALTH CONNECTIONS DENTAL PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01First time form 5500 has been submittedYes
2012-01-01Submission has been amendedNo
2012-01-01This submission is the final filingNo
2012-01-01This return/report is a short plan year return/report (less than 12 months)No
2012-01-01Plan is a collectively bargained planNo
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

ALTUS DENTAL INSURANCE COMPANY, INC. (National Association of Insurance Commissioners NAIC id number: 52632 )
Policy contract number1490_1
Policy instance 1
Insurance contract or identification number1490_1
Number of Individuals Covered142
Insurance policy start date2017-03-01
Insurance policy end date2018-02-28
Total amount of commissions paid to insurance brokerUSD $6,568
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 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 $65,682
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,095
Insurance broker organization code?3
Insurance broker nameDIGITAL INSURANCE INC.
BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. (National Association of Insurance Commissioners NAIC id number: 53228 )
Policy contract number4957740
Policy instance 1
Insurance contract or identification number4957740
Number of Individuals Covered50
Insurance policy start date2015-03-01
Insurance policy end date2016-02-29
Total amount of commissions paid to insurance brokerUSD $2,576
Total amount of fees paid to insurance companyUSD $4,761
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 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 $2,576
Amount paid for insurance broker fees4761
Insurance broker organization code?3
Insurance broker nameDIGITAL INSURANCE, INC.
BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. (National Association of Insurance Commissioners NAIC id number: 53228 )
Policy contract number4957740
Policy instance 1
Insurance contract or identification number4957740
Number of Individuals Covered61
Insurance policy start date2014-03-01
Insurance policy end date2015-02-28
Total amount of commissions paid to insurance brokerUSD $2,300
Total amount of fees paid to insurance companyUSD $14,355
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 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 $2,300
Insurance broker organization code?3
Insurance broker nameDIGITAL INSURANCE INC.
DELTA DENTAL OF MASSACHUSETTS (National Association of Insurance Commissioners NAIC id number: 52060 )
Policy contract number000660
Policy instance 1
Insurance contract or identification number000660
Number of Individuals Covered151
Insurance policy start date2013-03-01
Insurance policy end date2014-02-28
Total amount of commissions paid to insurance brokerUSD $5,294
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 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 $4
Insurance broker organization code?3
Insurance broker nameDIGITAL INSURANCE, INC.
DELTA DENTAL OF MASSACHUSETTS (National Association of Insurance Commissioners NAIC id number: 52060 )
Policy contract number000660
Policy instance 1
Insurance contract or identification number000660
Number of Individuals Covered156
Insurance policy start date2012-03-01
Insurance policy end date2013-02-28
Total amount of commissions paid to insurance brokerUSD $5,288
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,288
Insurance broker organization code?3
Insurance broker nameJOHN SIRACUSA

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