401k Plan data: PINE REST CHRISTIAN MENTAL HEALTH SERVICES ADD PLAN plan

PINE REST CHRISTIAN MENTAL HEALTH SERVICES ADD PLAN 401k Plan overview

Plan Name	PINE REST CHRISTIAN MENTAL HEALTH SERVICES ADD PLAN
Plan identification number	504

PINE REST CHRISTIAN MENTAL HEALTH SERVICES ADD PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Life insurance Death benefits (include travel accident but not life insurance)

401k Sponsoring company profile

PINE REST CHRISTIAN MENTAL HEALTH SERVICES has sponsored the creation of one or more 401k plans.

Company Name: PINE REST CHRISTIAN MENTAL HEALTH SERVICES

Employer identification number (EIN): 381368360

NAIC Classification: 622000
NAIC Description: Hospitals

Additional information about PINE REST CHRISTIAN MENTAL HEALTH SERVICES

Jurisdiction of Incorporation: Michigan Department of Licensing & Regulatory Affairs

Incorporation Date:

Company Identification Number: 841032

More information about PINE REST CHRISTIAN MENTAL HEALTH SERVICES

Form 5500 Filing Information

Submission information for form 5500 for 401k plan PINE REST CHRISTIAN MENTAL HEALTH SERVICES ADD PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
504 2017-07-01
504 2017-07-01 SUZANNE BOLT 2020-03-05
504 2016-07-01
504 2015-07-01 SUZANNE BOLT
504 2014-07-01 MARY DALE
504 2013-07-01 ANDREW GEORGE
504 2012-07-01 ANDREW GEORGE
504 2011-07-01 ANDREW GEORGE
504 2009-07-01 ANDREW GEORGE
504 2008-07-01 ANDREW GEORGE 2010-01-28

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
504	2017-07-01
504	2017-07-01	SUZANNE BOLT	2020-03-05
504	2016-07-01
504	2015-07-01	SUZANNE BOLT
504	2014-07-01	MARY DALE
504	2013-07-01	ANDREW GEORGE
504	2012-07-01	ANDREW GEORGE
504	2011-07-01	ANDREW GEORGE
504	2009-07-01	ANDREW GEORGE
504	2008-07-01			ANDREW GEORGE	2010-01-28

Plan Statistics for PINE REST CHRISTIAN MENTAL HEALTH SERVICES ADD PLAN

401k plan membership statisitcs for PINE REST CHRISTIAN MENTAL HEALTH SERVICES ADD PLAN

Measure Date Value
2017: PINE REST CHRISTIAN MENTAL HEALTH SERVICES ADD PLAN 2017 401k membership
Total participants, beginning-of-year 2017-07-01 879
Total number of active participants reported on line 7a of the Form 5500 2017-07-01 879
Number of retired or separated participants receiving benefits 2017-07-01 0
Number of other retired or separated participants entitled to future benefits 2017-07-01 0
Total of all active and inactive participants 2017-07-01 879
Number of employers contributing to the scheme 2017-07-01 0
2016: PINE REST CHRISTIAN MENTAL HEALTH SERVICES ADD PLAN 2016 401k membership
Total participants, beginning-of-year 2016-07-01 879
Total number of active participants reported on line 7a of the Form 5500 2016-07-01 879
Number of retired or separated participants receiving benefits 2016-07-01 0
Number of other retired or separated participants entitled to future benefits 2016-07-01 0
Total of all active and inactive participants 2016-07-01 879
2015: PINE REST CHRISTIAN MENTAL HEALTH SERVICES ADD PLAN 2015 401k membership
Total participants, beginning-of-year 2015-07-01 879
Total number of active participants reported on line 7a of the Form 5500 2015-07-01 879
Number of retired or separated participants receiving benefits 2015-07-01 0
Number of other retired or separated participants entitled to future benefits 2015-07-01 0
Total of all active and inactive participants 2015-07-01 879
2014: PINE REST CHRISTIAN MENTAL HEALTH SERVICES ADD PLAN 2014 401k membership
Total participants, beginning-of-year 2014-07-01 879
Total number of active participants reported on line 7a of the Form 5500 2014-07-01 879
Number of retired or separated participants receiving benefits 2014-07-01 0
Number of other retired or separated participants entitled to future benefits 2014-07-01 0
Total of all active and inactive participants 2014-07-01 879
2013: PINE REST CHRISTIAN MENTAL HEALTH SERVICES ADD PLAN 2013 401k membership
Total participants, beginning-of-year 2013-07-01 879
Total number of active participants reported on line 7a of the Form 5500 2013-07-01 879
Number of retired or separated participants receiving benefits 2013-07-01 0
Number of other retired or separated participants entitled to future benefits 2013-07-01 0
Total of all active and inactive participants 2013-07-01 879
2012: PINE REST CHRISTIAN MENTAL HEALTH SERVICES ADD PLAN 2012 401k membership
Total participants, beginning-of-year 2012-07-01 879
Total number of active participants reported on line 7a of the Form 5500 2012-07-01 879
Number of retired or separated participants receiving benefits 2012-07-01 0
Number of other retired or separated participants entitled to future benefits 2012-07-01 0
Total of all active and inactive participants 2012-07-01 879
2011: PINE REST CHRISTIAN MENTAL HEALTH SERVICES ADD PLAN 2011 401k membership
Total participants, beginning-of-year 2011-07-01 817
Total number of active participants reported on line 7a of the Form 5500 2011-07-01 879
Number of retired or separated participants receiving benefits 2011-07-01 0
Number of other retired or separated participants entitled to future benefits 2011-07-01 0
Total of all active and inactive participants 2011-07-01 879
2009: PINE REST CHRISTIAN MENTAL HEALTH SERVICES ADD PLAN 2009 401k membership
Total participants, beginning-of-year 2009-07-01 774
Total number of active participants reported on line 7a of the Form 5500 2009-07-01 779
Total of all active and inactive participants 2009-07-01 779
Total participants 2009-07-01 779
2008: PINE REST CHRISTIAN MENTAL HEALTH SERVICES ADD PLAN 2008 401k membership
Total participants, beginning-of-year 2008-07-01 720
Total number of active participants reported on line 7a of the Form 5500 2008-07-01 774
Number of retired or separated participants receiving benefits 2008-07-01 0
Number of other retired or separated participants entitled to future benefits 2008-07-01 0
Total of all active and inactive participants 2008-07-01 774
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2008-07-01 0
Total participants 2008-07-01 774

Measure	Date	Value
2017: PINE REST CHRISTIAN MENTAL HEALTH SERVICES ADD PLAN 2017 401k membership
Total participants, beginning-of-year	2017-07-01	879
Total number of active participants reported on line 7a of the Form 5500	2017-07-01	879
Number of retired or separated participants receiving benefits	2017-07-01	0
Number of other retired or separated participants entitled to future benefits	2017-07-01	0
Total of all active and inactive participants	2017-07-01	879
Number of employers contributing to the scheme	2017-07-01	0
2016: PINE REST CHRISTIAN MENTAL HEALTH SERVICES ADD PLAN 2016 401k membership
Total participants, beginning-of-year	2016-07-01	879
Total number of active participants reported on line 7a of the Form 5500	2016-07-01	879
Number of retired or separated participants receiving benefits	2016-07-01	0
Number of other retired or separated participants entitled to future benefits	2016-07-01	0
Total of all active and inactive participants	2016-07-01	879
2015: PINE REST CHRISTIAN MENTAL HEALTH SERVICES ADD PLAN 2015 401k membership
Total participants, beginning-of-year	2015-07-01	879
Total number of active participants reported on line 7a of the Form 5500	2015-07-01	879
Number of retired or separated participants receiving benefits	2015-07-01	0
Number of other retired or separated participants entitled to future benefits	2015-07-01	0
Total of all active and inactive participants	2015-07-01	879
2014: PINE REST CHRISTIAN MENTAL HEALTH SERVICES ADD PLAN 2014 401k membership
Total participants, beginning-of-year	2014-07-01	879
Total number of active participants reported on line 7a of the Form 5500	2014-07-01	879
Number of retired or separated participants receiving benefits	2014-07-01	0
Number of other retired or separated participants entitled to future benefits	2014-07-01	0
Total of all active and inactive participants	2014-07-01	879
2013: PINE REST CHRISTIAN MENTAL HEALTH SERVICES ADD PLAN 2013 401k membership
Total participants, beginning-of-year	2013-07-01	879
Total number of active participants reported on line 7a of the Form 5500	2013-07-01	879
Number of retired or separated participants receiving benefits	2013-07-01	0
Number of other retired or separated participants entitled to future benefits	2013-07-01	0
Total of all active and inactive participants	2013-07-01	879
2012: PINE REST CHRISTIAN MENTAL HEALTH SERVICES ADD PLAN 2012 401k membership
Total participants, beginning-of-year	2012-07-01	879
Total number of active participants reported on line 7a of the Form 5500	2012-07-01	879
Number of retired or separated participants receiving benefits	2012-07-01	0
Number of other retired or separated participants entitled to future benefits	2012-07-01	0
Total of all active and inactive participants	2012-07-01	879
2011: PINE REST CHRISTIAN MENTAL HEALTH SERVICES ADD PLAN 2011 401k membership
Total participants, beginning-of-year	2011-07-01	817
Total number of active participants reported on line 7a of the Form 5500	2011-07-01	879
Number of retired or separated participants receiving benefits	2011-07-01	0
Number of other retired or separated participants entitled to future benefits	2011-07-01	0
Total of all active and inactive participants	2011-07-01	879
2009: PINE REST CHRISTIAN MENTAL HEALTH SERVICES ADD PLAN 2009 401k membership
Total participants, beginning-of-year	2009-07-01	774
Total number of active participants reported on line 7a of the Form 5500	2009-07-01	779
Total of all active and inactive participants	2009-07-01	779
Total participants	2009-07-01	779
2008: PINE REST CHRISTIAN MENTAL HEALTH SERVICES ADD PLAN 2008 401k membership
Total participants, beginning-of-year	2008-07-01	720
Total number of active participants reported on line 7a of the Form 5500	2008-07-01	774
Number of retired or separated participants receiving benefits	2008-07-01	0
Number of other retired or separated participants entitled to future benefits	2008-07-01	0
Total of all active and inactive participants	2008-07-01	774
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2008-07-01	0
Total participants	2008-07-01	774

Form 5500 Responses for PINE REST CHRISTIAN MENTAL HEALTH SERVICES ADD PLAN

2017: PINE REST CHRISTIAN MENTAL HEALTH SERVICES ADD PLAN 2017 form 5500 responses
2017-07-01	Type of plan entity	Single employer plan
2017-07-01	Submission has been amended	Yes
2017-07-01	This submission is the final filing	Yes
2017-07-01	Plan funding arrangement – Insurance	Yes
2017-07-01	Plan benefit arrangement – Insurance	Yes
2016: PINE REST CHRISTIAN MENTAL HEALTH SERVICES ADD PLAN 2016 form 5500 responses
2016-07-01	Type of plan entity	Single employer plan
2016-07-01	Submission has been amended	No
2016-07-01	This submission is the final filing	No
2016-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-07-01	Plan is a collectively bargained plan	No
2016-07-01	Plan funding arrangement – Insurance	Yes
2016-07-01	Plan benefit arrangement – Insurance	Yes
2015: PINE REST CHRISTIAN MENTAL HEALTH SERVICES ADD PLAN 2015 form 5500 responses
2015-07-01	Type of plan entity	Single employer plan
2015-07-01	Submission has been amended	No
2015-07-01	This submission is the final filing	No
2015-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-07-01	Plan is a collectively bargained plan	No
2015-07-01	Plan funding arrangement – Insurance	Yes
2015-07-01	Plan benefit arrangement – Insurance	Yes
2014: PINE REST CHRISTIAN MENTAL HEALTH SERVICES ADD PLAN 2014 form 5500 responses
2014-07-01	Type of plan entity	Single employer plan
2014-07-01	Submission has been amended	No
2014-07-01	This submission is the final filing	No
2014-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-07-01	Plan is a collectively bargained plan	No
2014-07-01	Plan funding arrangement – Insurance	Yes
2014-07-01	Plan benefit arrangement – Insurance	Yes
2013: PINE REST CHRISTIAN MENTAL HEALTH SERVICES ADD PLAN 2013 form 5500 responses
2013-07-01	Type of plan entity	Single employer plan
2013-07-01	Submission has been amended	No
2013-07-01	This submission is the final filing	No
2013-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-07-01	Plan is a collectively bargained plan	No
2013-07-01	Plan funding arrangement – Insurance	Yes
2013-07-01	Plan benefit arrangement – Insurance	Yes
2012: PINE REST CHRISTIAN MENTAL HEALTH SERVICES ADD PLAN 2012 form 5500 responses
2012-07-01	Type of plan entity	Single employer plan
2012-07-01	Submission has been amended	No
2012-07-01	This submission is the final filing	No
2012-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-07-01	Plan is a collectively bargained plan	No
2012-07-01	Plan funding arrangement – Insurance	Yes
2012-07-01	Plan benefit arrangement – Insurance	Yes
2011: PINE REST CHRISTIAN MENTAL HEALTH SERVICES ADD PLAN 2011 form 5500 responses
2011-07-01	Type of plan entity	Single employer plan
2011-07-01	Submission has been amended	No
2011-07-01	This submission is the final filing	No
2011-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-07-01	Plan is a collectively bargained plan	No
2011-07-01	Plan funding arrangement – Insurance	Yes
2011-07-01	Plan benefit arrangement – Insurance	Yes
2009: PINE REST CHRISTIAN MENTAL HEALTH SERVICES ADD PLAN 2009 form 5500 responses
2009-07-01	Type of plan entity	Single employer plan
2009-07-01	Submission has been amended	No
2009-07-01	This submission is the final filing	No
2009-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-07-01	Plan is a collectively bargained plan	No
2009-07-01	Plan funding arrangement – Insurance	Yes
2009-07-01	Plan benefit arrangement – Insurance	Yes
2008: PINE REST CHRISTIAN MENTAL HEALTH SERVICES ADD PLAN 2008 form 5500 responses
2008-07-01	Type of plan entity	Single employer plan
2008-07-01	Submission has been amended	No
2008-07-01	This submission is the final filing	No
2008-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2008-07-01	Plan is a collectively bargained plan	No
2008-07-01	Plan funding arrangement – Insurance	Yes
2008-07-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

OK961959

Policy instance

Insurance contract or identification number	OK961959
Number of Individuals Covered	879
Insurance policy start date	2017-07-01
Insurance policy end date	2018-06-30
Total amount of commissions paid to insurance broker	USD $3,371
Total amount of fees paid to insurance company	USD $0
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to Carrier	USD $32,414
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	Yes
Commission paid to Insurance Broker	USD $3,371
Amount paid for insurance broker fees	0
Insurance broker organization code?	3
Insurance broker name	BUITEN AND ASSOCIATES, LLC

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Company Name:	PINE REST CHRISTIAN MENTAL HEALTH SERVICES
Employer identification number (EIN):	381368360
NAIC Classification:	622000
NAIC Description:	Hospitals

Jurisdiction of Incorporation:	Michigan Department of Licensing & Regulatory Affairs
Incorporation Date:
Company Identification Number:	841032