401k Plan data: COOPERATIVE MANAGED CARE SERVICES SHORT-TERM DISABILITY PLAN plan

COOPERATIVE MANAGED CARE SERVICES SHORT-TERM DISABILITY PLAN 401k Plan overview

Plan Name	COOPERATIVE MANAGED CARE SERVICES SHORT-TERM DISABILITY PLAN
Plan identification number	504

COOPERATIVE MANAGED CARE SERVICES SHORT-TERM DISABILITY PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Temporary disability (accident and sickness)

401k Sponsoring company profile

COOPERATIVE MANAGED CARE SERVICES, LLC has sponsored the creation of one or more 401k plans.

Company Name: COOPERATIVE MANAGED CARE SERVICES, LLC

Employer identification number (EIN): 351999227

NAIC Classification: 524290

Form 5500 Filing Information

Submission information for form 5500 for 401k plan COOPERATIVE MANAGED CARE SERVICES SHORT-TERM DISABILITY PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
504 2016-01-01 TOM KLAGES TOM KLAGES 2017-06-28
504 2014-01-01 TOM KLAGES TOM KLAGES 2015-07-02
504 2013-01-01 TOM KLAGES TOM KLAGES 2014-07-24
504 2012-01-01 KATIE GRAY

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
504	2016-01-01	TOM KLAGES	TOM KLAGES	2017-06-28
504	2014-01-01	TOM KLAGES	TOM KLAGES	2015-07-02
504	2013-01-01	TOM KLAGES	TOM KLAGES	2014-07-24
504	2012-01-01	KATIE GRAY

Plan Statistics for COOPERATIVE MANAGED CARE SERVICES SHORT-TERM DISABILITY PLAN

401k plan membership statisitcs for COOPERATIVE MANAGED CARE SERVICES SHORT-TERM DISABILITY PLAN

Measure Date Value
2016: COOPERATIVE MANAGED CARE SERVICES SHORT-TERM DISABILITY PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 119
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 106
Total of all active and inactive participants 2016-01-01 106
Total participants 2016-01-01 106
2014: COOPERATIVE MANAGED CARE SERVICES SHORT-TERM DISABILITY PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 115
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 125
Total of all active and inactive participants 2014-01-01 125
Total participants 2014-01-01 125
2013: COOPERATIVE MANAGED CARE SERVICES SHORT-TERM DISABILITY PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 114
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 120
Total of all active and inactive participants 2013-01-01 120
Total participants 2013-01-01 120
2012: COOPERATIVE MANAGED CARE SERVICES SHORT-TERM DISABILITY PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 102
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 114
Number of retired or separated participants receiving benefits 2012-01-01 0
Number of other retired or separated participants entitled to future benefits 2012-01-01 0
Total of all active and inactive participants 2012-01-01 114
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 114
Number of participants with account balances 2012-01-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 0

Measure	Date	Value
2016: COOPERATIVE MANAGED CARE SERVICES SHORT-TERM DISABILITY PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	119
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	106
Total of all active and inactive participants	2016-01-01	106
Total participants	2016-01-01	106
2014: COOPERATIVE MANAGED CARE SERVICES SHORT-TERM DISABILITY PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	115
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	125
Total of all active and inactive participants	2014-01-01	125
Total participants	2014-01-01	125
2013: COOPERATIVE MANAGED CARE SERVICES SHORT-TERM DISABILITY PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	114
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	120
Total of all active and inactive participants	2013-01-01	120
Total participants	2013-01-01	120
2012: COOPERATIVE MANAGED CARE SERVICES SHORT-TERM DISABILITY PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	102
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	114
Number of retired or separated participants receiving benefits	2012-01-01	0
Number of other retired or separated participants entitled to future benefits	2012-01-01	0
Total of all active and inactive participants	2012-01-01	114
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	114
Number of participants with account balances	2012-01-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	0

Form 5500 Responses for COOPERATIVE MANAGED CARE SERVICES SHORT-TERM DISABILITY PLAN

2016: COOPERATIVE MANAGED CARE SERVICES SHORT-TERM DISABILITY PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Submission has been amended	No
2016-01-01	This submission is the final filing	No
2016-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-01-01	Plan is a collectively bargained plan	No
2016-01-01	Plan funding arrangement – Insurance	Yes
2016-01-01	Plan benefit arrangement – Insurance	Yes
2014: COOPERATIVE MANAGED CARE SERVICES SHORT-TERM DISABILITY PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	First time form 5500 has been submitted	Yes
2014-01-01	Submission has been amended	No
2014-01-01	This submission is the final filing	No
2014-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-01-01	Plan is a collectively bargained plan	No
2014-01-01	Plan funding arrangement – Insurance	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes
2013: COOPERATIVE MANAGED CARE SERVICES SHORT-TERM DISABILITY PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	First time form 5500 has been submitted	Yes
2013-01-01	Submission has been amended	No
2013-01-01	This submission is the final filing	No
2013-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-01-01	Plan is a collectively bargained plan	No
2013-01-01	Plan funding arrangement – Insurance	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2012: COOPERATIVE MANAGED CARE SERVICES SHORT-TERM DISABILITY PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	First time form 5500 has been submitted	Yes
2012-01-01	Submission has been amended	Yes
2012-01-01	This submission is the final filing	No
2012-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-01-01	Plan is a collectively bargained plan	No
2012-01-01	Plan funding arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes

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Company Name:	COOPERATIVE MANAGED CARE SERVICES, LLC
Employer identification number (EIN):	351999227
NAIC Classification:	524290