401k Plan data: PBHM 401(K) PROFIT SHARING PLAN plan

PBHM 401(K) PROFIT SHARING PLAN 401k Plan overview

Plan Name	PBHM 401(K) PROFIT SHARING PLAN
Plan identification number	001

PBHM 401(K) PROFIT SHARING PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

Profit-sharing
ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.

401k Sponsoring company profile

PERSPECTIVE BEHAVIORAL HEALTH MANAGEMENT, LLC has sponsored the creation of one or more 401k plans.

Company Name: PERSPECTIVE BEHAVIORAL HEALTH MANAGEMENT, LLC

Employer identification number (EIN): 331048513

NAIC Classification: 621330
NAIC Description: Offices of Mental Health Practitioners (except Physicians)

Form 5500 Filing Information

Submission information for form 5500 for 401k plan PBHM 401(K) PROFIT SHARING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2022-01-01 ROBERT CRAIN 2023-10-16
001 2021-01-01 ROBERT CRAIN 2022-10-17
001 2020-01-01 ROBERT CRAIN 2021-10-15
001 2018-01-01 CHRIS VONDERHEIDE 2019-09-30
001 2017-01-01 CHRIS VONDERHEIDE 2018-06-13
001 2016-01-01 CHRIS VONDERHEIDE
001 2015-01-01 CHRIS VONDERHEIDE

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
001	2022-01-01	ROBERT CRAIN	2023-10-16
001	2021-01-01	ROBERT CRAIN	2022-10-17
001	2020-01-01	ROBERT CRAIN	2021-10-15
001	2018-01-01	CHRIS VONDERHEIDE	2019-09-30
001	2017-01-01	CHRIS VONDERHEIDE	2018-06-13
001	2016-01-01	CHRIS VONDERHEIDE
001	2015-01-01	CHRIS VONDERHEIDE

Plan Statistics for PBHM 401(K) PROFIT SHARING PLAN

401k plan membership statisitcs for PBHM 401(K) PROFIT SHARING PLAN

Measure Date Value
2016: PBHM 401(K) PROFIT SHARING PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 100
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 73
Number of retired or separated participants receiving benefits 2016-01-01 0
Number of other retired or separated participants entitled to future benefits 2016-01-01 24
Total of all active and inactive participants 2016-01-01 97
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
Total participants 2016-01-01 97
Number of participants with account balances 2016-01-01 61
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 0
2015: PBHM 401(K) PROFIT SHARING PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 104
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 80
Number of retired or separated participants receiving benefits 2015-01-01 0
Number of other retired or separated participants entitled to future benefits 2015-01-01 20
Total of all active and inactive participants 2015-01-01 100
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 100
Number of participants with account balances 2015-01-01 61

Measure	Date	Value
2016: PBHM 401(K) PROFIT SHARING PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	100
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	73
Number of retired or separated participants receiving benefits	2016-01-01	0
Number of other retired or separated participants entitled to future benefits	2016-01-01	24
Total of all active and inactive participants	2016-01-01	97
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	97
Number of participants with account balances	2016-01-01	61
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	0
2015: PBHM 401(K) PROFIT SHARING PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	104
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	80
Number of retired or separated participants receiving benefits	2015-01-01	0
Number of other retired or separated participants entitled to future benefits	2015-01-01	20
Total of all active and inactive participants	2015-01-01	100
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	100
Number of participants with account balances	2015-01-01	61

Financial Data on PBHM 401(K) PROFIT SHARING PLAN

Measure	Date	Value
2016 : PBHM 401(K) PROFIT SHARING PLAN 2016 401k financial data
Total income from all sources (including contributions)	2016-12-31	$297,387
Total of all expenses incurred	2016-12-31	$73,467
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-12-31	$67,266
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-12-31	$204,238
Value of total assets at end of year	2016-12-31	$1,507,884
Value of total assets at beginning of year	2016-12-31	$1,283,964
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-12-31	$6,201
Total interest from all sources	2016-12-31	$2,690
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2016-12-31	No
Was this plan covered by a fidelity bond	2016-12-31	Yes
Value of fidelity bond cover	2016-12-31	$200,000
If this is an individual account plan, was there a blackout period	2016-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2016-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2016-12-31	No
Contributions received from participants	2016-12-31	$117,241
Participant contributions at end of year	2016-12-31	$59,613
Participant contributions at beginning of year	2016-12-31	$67,478
Other income not declared elsewhere	2016-12-31	$716
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-12-31	No
Value of net income/loss	2016-12-31	$223,920
Value of net assets at end of year (total assets less liabilities)	2016-12-31	$1,507,884
Value of net assets at beginning of year (total assets less liabilities)	2016-12-31	$1,283,964
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2016-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2016-12-31	No
Were any leases to which the plan was party in default or uncollectible	2016-12-31	No
Value of interest in pooled separate accounts at end of year	2016-12-31	$1,439,417
Value of interest in pooled separate accounts at beginning of year	2016-12-31	$1,208,313
Interest on participant loans	2016-12-31	$2,690
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2016-12-31	$8,854
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2016-12-31	$8,173
Net investment gain/loss from pooled separate accounts	2016-12-31	$89,743
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2016-12-31	No
Was there a failure to transmit to the plan any participant contributions	2016-12-31	No
Has the plan failed to provide any benefit when due under the plan	2016-12-31	No
Contributions received in cash from employer	2016-12-31	$86,997
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2016-12-31	$67,266
Contract administrator fees	2016-12-31	$6,201
Did the plan have assets held for investment	2016-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2016-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2016-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2016-12-31	Disclaimer
Accountancy firm name	2016-12-31	JOHN LANGHAM & CO., CPAS
Accountancy firm EIN	2016-12-31	710747668
2015 : PBHM 401(K) PROFIT SHARING PLAN 2015 401k financial data
Total transfer of assets to this plan	2015-12-31	$1,380,798
Total income from all sources (including contributions)	2015-12-31	$138,900
Total of all expenses incurred	2015-12-31	$235,734
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-12-31	$232,174
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-12-31	$199,825
Value of total assets at end of year	2015-12-31	$1,283,964
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-12-31	$3,560
Total interest from all sources	2015-12-31	$956
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2015-12-31	No
Was this plan covered by a fidelity bond	2015-12-31	Yes
Value of fidelity bond cover	2015-12-31	$200,000
If this is an individual account plan, was there a blackout period	2015-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2015-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2015-12-31	No
Contributions received from participants	2015-12-31	$119,034
Participant contributions at end of year	2015-12-31	$67,478
Income. Received or receivable in cash from other sources (including rollovers)	2015-12-31	$88
Other income not declared elsewhere	2015-12-31	$61
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-12-31	No
Value of net income/loss	2015-12-31	$-96,834
Value of net assets at end of year (total assets less liabilities)	2015-12-31	$1,283,964
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2015-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2015-12-31	No
Were any leases to which the plan was party in default or uncollectible	2015-12-31	No
Value of interest in pooled separate accounts at end of year	2015-12-31	$1,208,313
Income. Interest from US Government securities	2015-12-31	$956
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2015-12-31	$8,173
Net investment gain/loss from pooled separate accounts	2015-12-31	$-61,942
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2015-12-31	No
Was there a failure to transmit to the plan any participant contributions	2015-12-31	No
Has the plan failed to provide any benefit when due under the plan	2015-12-31	No
Contributions received in cash from employer	2015-12-31	$80,703
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2015-12-31	$232,174
Contract administrator fees	2015-12-31	$3,560
Did the plan have assets held for investment	2015-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2015-12-31	No
Accountancy firm name	2015-12-31	JOHN LANGHAM & CO., CPAS
Accountancy firm EIN	2015-12-31	710747668

Form 5500 Responses for PBHM 401(K) PROFIT SHARING PLAN

2016: PBHM 401(K) PROFIT SHARING PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Plan funding arrangement – Insurance	Yes
2016-01-01	Plan funding arrangement – Trust	Yes
2016-01-01	Plan benefit arrangement – Insurance	Yes
2016-01-01	Plan benefit arrangement - Trust	Yes
2015: PBHM 401(K) PROFIT SHARING PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	First time form 5500 has been submitted	Yes
2015-01-01	Plan funding arrangement – Insurance	Yes
2015-01-01	Plan funding arrangement – Trust	Yes
2015-01-01	Plan benefit arrangement – Insurance	Yes
2015-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )

Policy contract number

8062740000

Policy instance

Insurance contract or identification number	8062740000
Number of Individuals Covered	61
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $2,797
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,797
Insurance broker organization code?	3
Insurance broker name	MARK R MYERS

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Company Name:	PERSPECTIVE BEHAVIORAL HEALTH MANAGEMENT, LLC
Employer identification number (EIN):	331048513
NAIC Classification:	621330
NAIC Description:	Offices of Mental Health Practitioners (except Physicians)