401k Plan data: CGS FAMILY PARTNERSHIP INC. HEALTH & WELFARE BENEFITS PLAN plan

CGS FAMILY PARTNERSHIP INC. HEALTH & WELFARE BENEFITS PLAN 401k Plan overview

Plan Name	CGS FAMILY PARTNERSHIP INC. HEALTH & WELFARE BENEFITS PLAN
Plan identification number	501

CGS FAMILY PARTNERSHIP INC. HEALTH & WELFARE BENEFITS PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) Life insurance Dental Vision Long-term disability cover Death benefits (include travel accident but not life insurance) Other welfare benefit cover

401k Sponsoring company profile

CGS FAMILY PARTNERSHIP INC has sponsored the creation of one or more 401k plans.

Company Name: CGS FAMILY PARTNERSHIP INC

Employer identification number (EIN): 202736415

NAIC Classification: 624100
NAIC Description: Individual and Family Services

Form 5500 Filing Information

Submission information for form 5500 for 401k plan CGS FAMILY PARTNERSHIP INC. HEALTH & WELFARE BENEFITS PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2023-01-01 BETH NOBLES 2024-05-21

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
501	2023-01-01	BETH NOBLES	2024-05-21

Plan Statistics for CGS FAMILY PARTNERSHIP INC. HEALTH & WELFARE BENEFITS PLAN

401k plan membership statisitcs for CGS FAMILY PARTNERSHIP INC. HEALTH & WELFARE BENEFITS PLAN

Measure Date Value
2023: CGS FAMILY PARTNERSHIP INC. HEALTH & WELFARE BENEFITS PLAN 2023 401k membership
Total participants, beginning-of-year 2023-01-01 107
Total number of active participants reported on line 7a of the Form 5500 2023-01-01 104
Number of retired or separated participants receiving benefits 2023-01-01 0
Number of other retired or separated participants entitled to future benefits 2023-01-01 0
Total of all active and inactive participants 2023-01-01 104
Number of employers contributing to the scheme 2023-01-01 0

Measure	Date	Value
2023: CGS FAMILY PARTNERSHIP INC. HEALTH & WELFARE BENEFITS PLAN 2023 401k membership
Total participants, beginning-of-year	2023-01-01	107
Total number of active participants reported on line 7a of the Form 5500	2023-01-01	104
Number of retired or separated participants receiving benefits	2023-01-01	0
Number of other retired or separated participants entitled to future benefits	2023-01-01	0
Total of all active and inactive participants	2023-01-01	104
Number of employers contributing to the scheme	2023-01-01	0

Form 5500 Responses for CGS FAMILY PARTNERSHIP INC. HEALTH & WELFARE BENEFITS PLAN

2023: CGS FAMILY PARTNERSHIP INC. HEALTH & WELFARE BENEFITS PLAN 2023 form 5500 responses
2023-01-01	Type of plan entity	Single employer plan
2023-01-01	First time form 5500 has been submitted	Yes
2023-01-01	Plan funding arrangement – Insurance	Yes
2023-01-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

ALPHA DENTAL PROGRAMS, INC. (National Association of Insurance Commissioners NAIC id number: 95163 )

Policy contract number

79289

Policy instance

Insurance contract or identification number	79289
Number of Individuals Covered	34
Insurance policy start date	2023-01-01
Insurance policy end date	2023-12-31
Total amount of commissions paid to insurance broker	USD $492
Total amount of fees paid to insurance company	USD $0
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $6,150
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	Yes

SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )

Policy contract number

921956

Policy instance

Insurance contract or identification number	921956
Number of Individuals Covered	103
Insurance policy start date	2023-01-01
Insurance policy end date	2023-12-31
Total amount of commissions paid to insurance broker	USD $5,171
Total amount of fees paid to insurance company	USD $1,368
Life Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to Carrier	USD $35,986
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

HEALTH ADVOCATE, INC. (National Association of Insurance Commissioners NAIC id number: 54160 )

Policy contract number

CGS FAMILY PART

Policy instance

Insurance contract or identification number	CGS FAMILY PART
Number of Individuals Covered	109
Insurance policy start date	2023-01-01
Insurance policy end date	2023-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Other welfare benefits provided	EMPLOYEE ASSISTANCE PROGRAM
Welfare Benefit Premiums Paid to Carrier	USD $4,800
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

DELTA DENTAL OF NJ INC (National Association of Insurance Commissioners NAIC id number: 55085 )

Policy contract number

10463

Policy instance

Insurance contract or identification number	10463
Number of Individuals Covered	135
Insurance policy start date	2023-01-01
Insurance policy end date	2023-12-31
Total amount of commissions paid to insurance broker	USD $3,747
Total amount of fees paid to insurance company	USD $0
Dental Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

HORIZON INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 14690 )

Policy contract number

8034A

Policy instance

Insurance contract or identification number	8034A
Number of Individuals Covered	82
Insurance policy start date	2023-01-01
Insurance policy end date	2023-12-31
Total amount of commissions paid to insurance broker	USD $811
Total amount of fees paid to insurance company	USD $0
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $8,105
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

HORIZON HEALTHCARE SERVICES, INC. (National Association of Insurance Commissioners NAIC id number: 55069 )

Policy contract number

8034A

Policy instance

Insurance contract or identification number	8034A
Number of Individuals Covered	82
Insurance policy start date	2023-01-01
Insurance policy end date	2023-12-31
Total amount of commissions paid to insurance broker	USD $64,283
Total amount of fees paid to insurance company	USD $13,945
Health Insurance Welfare Benefit	Yes
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Welfare Benefit Premiums Paid to Carrier	USD $1,394,439
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

Potentially related plans

CGS FAMILY SUPPORT ORGANIZATION 401(K) P/S PLAN [EIN = 202905491]

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Company Name:	CGS FAMILY PARTNERSHIP INC
Employer identification number (EIN):	202736415
NAIC Classification:	624100
NAIC Description:	Individual and Family Services