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ERIE COUNTY SOUTHEAST CORP. V 401k Plan overview

Plan NameERIE COUNTY SOUTHEAST CORP. V
Plan identification number 503

ERIE COUNTY SOUTHEAST CORP. V Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Dental

401k Sponsoring company profile

MENTAL HEALTH SERVICES, ERIE COUNTY SOUTH EAST CORP V has sponsored the creation of one or more 401k plans.

Company Name:MENTAL HEALTH SERVICES, ERIE COUNTY SOUTH EAST CORP V
Employer identification number (EIN):161019944
NAIC Classification:621420
NAIC Description:Outpatient Mental Health and Substance Abuse Centers

Form 5500 Filing Information

Submission information for form 5500 for 401k plan ERIE COUNTY SOUTHEAST CORP. V

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5032022-01-01
5032021-01-01
5032020-01-01
5032019-01-01
5032018-01-01MARK HENDRICKSON MARK HENDRICKSON2019-07-11
5032017-01-01MARK HENDRICKSON MARK HENDRICKSON2018-07-17
5032016-01-01MARK HENDRICKSON MARK HENDRICKSON2017-07-18
5032015-01-01DAVID WAWRZYNEK DAVID WAWRZYNEK2017-03-16
5032014-01-01DAVID WAWRZYNEK DAVID WAWRZYNEK2017-03-16
5032013-01-01MARK HENDRICKSON
5032012-01-01DAVID WAWRZYNEK DAVID WAWRZYNEK2017-03-16
5032011-01-01DAVID WAWRZYNEK DAVID WAWRZYNEK2017-03-16

Plan Statistics for ERIE COUNTY SOUTHEAST CORP. V

401k plan membership statisitcs for ERIE COUNTY SOUTHEAST CORP. V

Measure Date Value
2022: ERIE COUNTY SOUTHEAST CORP. V 2022 401k membership
Total participants, beginning-of-year2022-01-01235
Total number of active participants reported on line 7a of the Form 55002022-01-01204
Number of retired or separated participants receiving benefits2022-01-010
Number of other retired or separated participants entitled to future benefits2022-01-010
Total of all active and inactive participants2022-01-01204
2021: ERIE COUNTY SOUTHEAST CORP. V 2021 401k membership
Total participants, beginning-of-year2021-01-01242
Total number of active participants reported on line 7a of the Form 55002021-01-01233
Number of retired or separated participants receiving benefits2021-01-010
Total of all active and inactive participants2021-01-01233
2020: ERIE COUNTY SOUTHEAST CORP. V 2020 401k membership
Total participants, beginning-of-year2020-01-01229
Total number of active participants reported on line 7a of the Form 55002020-01-01234
Number of retired or separated participants receiving benefits2020-01-010
Total of all active and inactive participants2020-01-01234
2019: ERIE COUNTY SOUTHEAST CORP. V 2019 401k membership
Total participants, beginning-of-year2019-01-01214
Total number of active participants reported on line 7a of the Form 55002019-01-01210
Number of retired or separated participants receiving benefits2019-01-010
Total of all active and inactive participants2019-01-01210
2018: ERIE COUNTY SOUTHEAST CORP. V 2018 401k membership
Total participants, beginning-of-year2018-01-01178
Total number of active participants reported on line 7a of the Form 55002018-01-01190
Number of retired or separated participants receiving benefits2018-01-010
Total of all active and inactive participants2018-01-01190
2017: ERIE COUNTY SOUTHEAST CORP. V 2017 401k membership
Total participants, beginning-of-year2017-01-01161
Total number of active participants reported on line 7a of the Form 55002017-01-01168
Number of retired or separated participants receiving benefits2017-01-010
Total of all active and inactive participants2017-01-01168
2016: ERIE COUNTY SOUTHEAST CORP. V 2016 401k membership
Total participants, beginning-of-year2016-01-01138
Total number of active participants reported on line 7a of the Form 55002016-01-01141
Total of all active and inactive participants2016-01-01141
2015: ERIE COUNTY SOUTHEAST CORP. V 2015 401k membership
Total participants, beginning-of-year2015-01-01140
Total number of active participants reported on line 7a of the Form 55002015-01-01134
Total of all active and inactive participants2015-01-01134
2014: ERIE COUNTY SOUTHEAST CORP. V 2014 401k membership
Total participants, beginning-of-year2014-01-01138
Total number of active participants reported on line 7a of the Form 55002014-01-01140
Total of all active and inactive participants2014-01-01140
2013: ERIE COUNTY SOUTHEAST CORP. V 2013 401k membership
Total participants, beginning-of-year2013-01-01127
Total number of active participants reported on line 7a of the Form 55002013-01-01138
Total of all active and inactive participants2013-01-01138
2012: ERIE COUNTY SOUTHEAST CORP. V 2012 401k membership
Total participants, beginning-of-year2012-01-01115
Total number of active participants reported on line 7a of the Form 55002012-01-01127
Total of all active and inactive participants2012-01-01127
2011: ERIE COUNTY SOUTHEAST CORP. V 2011 401k membership
Total participants, beginning-of-year2011-01-0197
Total number of active participants reported on line 7a of the Form 55002011-01-01115
Total of all active and inactive participants2011-01-01115

Form 5500 Responses for ERIE COUNTY SOUTHEAST CORP. V

2022: ERIE COUNTY SOUTHEAST CORP. V 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan funding arrangement – General assets of the sponsorYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement – General assets of the sponsorYes
2021: ERIE COUNTY SOUTHEAST CORP. V 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan funding arrangement – General assets of the sponsorYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement – General assets of the sponsorYes
2020: ERIE COUNTY SOUTHEAST CORP. V 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan funding arrangement – General assets of the sponsorYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement – General assets of the sponsorYes
2019: ERIE COUNTY SOUTHEAST CORP. V 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan funding arrangement – General assets of the sponsorYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement – General assets of the sponsorYes
2018: ERIE COUNTY SOUTHEAST CORP. V 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan funding arrangement – General assets of the sponsorYes
2018-01-01Plan benefit arrangement – InsuranceYes
2018-01-01Plan benefit arrangement – General assets of the sponsorYes
2017: ERIE COUNTY SOUTHEAST CORP. V 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan funding arrangement – General assets of the sponsorYes
2017-01-01Plan benefit arrangement – InsuranceYes
2017-01-01Plan benefit arrangement – General assets of the sponsorYes
2016: ERIE COUNTY SOUTHEAST CORP. V 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan funding arrangement – General assets of the sponsorYes
2016-01-01Plan benefit arrangement – InsuranceYes
2016-01-01Plan benefit arrangement – General assets of the sponsorYes
2015: ERIE COUNTY SOUTHEAST CORP. V 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan funding arrangement – General assets of the sponsorYes
2015-01-01Plan benefit arrangement – InsuranceYes
2015-01-01Plan benefit arrangement – General assets of the sponsorYes
2014: ERIE COUNTY SOUTHEAST CORP. V 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan funding arrangement – General assets of the sponsorYes
2014-01-01Plan benefit arrangement – InsuranceYes
2014-01-01Plan benefit arrangement – General assets of the sponsorYes
2013: ERIE COUNTY SOUTHEAST CORP. V 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan funding arrangement – General assets of the sponsorYes
2013-01-01Plan benefit arrangement – InsuranceYes
2013-01-01Plan benefit arrangement – General assets of the sponsorYes
2012: ERIE COUNTY SOUTHEAST CORP. V 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan funding arrangement – General assets of the sponsorYes
2012-01-01Plan benefit arrangement – InsuranceYes
2012-01-01Plan benefit arrangement – General assets of the sponsorYes
2011: ERIE COUNTY SOUTHEAST CORP. V 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01First time form 5500 has been submittedYes
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan funding arrangement – General assets of the sponsorYes
2011-01-01Plan benefit arrangement – InsuranceYes
2011-01-01Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract numberTM05940975
Policy instance 1
Insurance contract or identification numberTM05940975
Number of Individuals Covered535
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $4,388
Total amount of fees paid to insurance companyUSD $3,649
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $139,579
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,388
Amount paid for insurance broker fees3649
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract numberTM05940975
Policy instance 1
Insurance contract or identification numberTM05940975
Number of Individuals Covered630
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $4,543
Total amount of fees paid to insurance companyUSD $57
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $179,538
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,212
Insurance broker organization code?3
Amount paid for insurance broker fees57
Additional information about fees paid to insurance brokerNON-MONETARY COMPENSATION
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract numberTM05940975
Policy instance 1
Insurance contract or identification numberTM05940975
Number of Individuals Covered542
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $2,963
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $117,539
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,963
Insurance broker organization code?3
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract numberTM05940975
Policy instance 1
Insurance contract or identification numberTM05940975
Number of Individuals Covered532
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $4,021
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $134,092
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,021
Insurance broker organization code?3
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract numberTM05940975
Policy instance 1
Insurance contract or identification numberTM05940975
Number of Individuals Covered440
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $3,701
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $118,706
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,701
Insurance broker organization code?3
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract numberTM05940975
Policy instance 1
Insurance contract or identification numberTM05940975
Number of Individuals Covered394
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $6,344
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $100,946
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,344
Amount paid for insurance broker fees0
Insurance broker organization code?3
Insurance broker nameTHE BERT COMPANY GROUP LLC
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00505646
Policy instance 1
Insurance contract or identification number00505646
Number of Individuals Covered134
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $3,929
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $88,426
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,929
Insurance broker nameLAWLEY BENEFITS GROUP LLC
LINCOLN LIFE AND ANNUITY CO OF NY (National Association of Insurance Commissioners NAIC id number: 62057 )
Policy contract number00001D022895
Policy instance 1
Insurance contract or identification number00001D022895
Number of Individuals Covered140
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $3,221
Total amount of fees paid to insurance companyUSD $924
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $91,395
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,350
Insurance broker organization code?3
Amount paid for insurance broker fees924
Additional information about fees paid to insurance brokerBROKER BONUS
Insurance broker nameLAWLEY BENEFITS GROUP LLC
LINCOLN LIFE AND ANNUITY CO OF NY (National Association of Insurance Commissioners NAIC id number: 62057 )
Policy contract number00001D022895
Policy instance 1
Insurance contract or identification number00001D022895
Number of Individuals Covered138
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $3,155
Total amount of fees paid to insurance companyUSD $610
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $87,001
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,155
Insurance broker organization code?3
Amount paid for insurance broker fees610
Additional information about fees paid to insurance brokerBROKER BONUS
Insurance broker nameBROWN & BROWN OF FL
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00293462
Policy instance 2
Insurance contract or identification number00293462
Number of Individuals Covered114
Insurance policy start date2012-01-01
Insurance policy end date2012-01-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $7,490
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
LINCOLN LIFE AND ANNUITY CO OF NY (National Association of Insurance Commissioners NAIC id number: 62057 )
Policy contract number00001D022895
Policy instance 1
Insurance contract or identification number00001D022895
Number of Individuals Covered127
Insurance policy start date2012-01-01
Insurance policy end date2012-01-01
Total amount of commissions paid to insurance brokerUSD $2,462
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $75,039
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,462
Insurance broker organization code?3
Insurance broker nameBROWN AND BROWN OF NEW YORK
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00293462
Policy instance 1
Insurance contract or identification number00293462
Number of Individuals Covered115
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $85,340
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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