401k Plan data: WOODLAND CENTERS EMPLOYEE MEDICAL BENEFIT PLAN plan

WOODLAND CENTERS EMPLOYEE MEDICAL BENEFIT PLAN 401k Plan overview

Plan Name	WOODLAND CENTERS EMPLOYEE MEDICAL BENEFIT PLAN
Plan identification number	501

WOODLAND CENTERS EMPLOYEE MEDICAL BENEFIT PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) Death benefits (include travel accident but not life insurance)

401k Sponsoring company profile

WOODLAND CENTERS has sponsored the creation of one or more 401k plans.

Company Name: WOODLAND CENTERS

Employer identification number (EIN): 410810019

NAIC Classification: 621399
NAIC Description: Offices of All Other Miscellaneous Health Practitioners

Form 5500 Filing Information

Submission information for form 5500 for 401k plan WOODLAND CENTERS EMPLOYEE MEDICAL BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2019-01-01
501 2019-01-01
501 2018-01-01 ASHLEY KJOS, PSY D ASHLEY KJOS, PSY D 2019-07-11
501 2017-01-01 ASHLEY KJOS, PSY D ASHLEY KJOS, PSY D 2018-07-26
501 2016-01-01 ASHLEY KJOS, PSY D ASHLEY KJOS, PSY D 2017-06-21
501 2015-01-01 ASHLEY KJOS, PSY D ASHLEY KJOS, PSY D 2016-06-09
501 2014-01-01 RICHARD LEE RICHARD LEE 2015-07-13
501 2013-10-01 LINDA HOCUM LINDA HOCUM 2014-09-19
501 2012-10-01 RICHARD LEE
501 2011-10-01 RICHARD LEE
501 2010-10-01 RICHARD LEE
501 2009-10-01 LINDA HOCUM 2011-04-28
501 2008-10-01

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
501	2019-01-01
501	2019-01-01
501	2018-01-01	ASHLEY KJOS, PSY D	ASHLEY KJOS, PSY D	2019-07-11
501	2017-01-01	ASHLEY KJOS, PSY D	ASHLEY KJOS, PSY D	2018-07-26
501	2016-01-01	ASHLEY KJOS, PSY D	ASHLEY KJOS, PSY D	2017-06-21
501	2015-01-01	ASHLEY KJOS, PSY D	ASHLEY KJOS, PSY D	2016-06-09
501	2014-01-01	RICHARD LEE	RICHARD LEE	2015-07-13
501	2013-10-01	LINDA HOCUM	LINDA HOCUM	2014-09-19
501	2012-10-01	RICHARD LEE
501	2011-10-01	RICHARD LEE
501	2010-10-01	RICHARD LEE
501	2009-10-01		LINDA HOCUM	2011-04-28
501	2008-10-01

Plan Statistics for WOODLAND CENTERS EMPLOYEE MEDICAL BENEFIT PLAN

401k plan membership statisitcs for WOODLAND CENTERS EMPLOYEE MEDICAL BENEFIT PLAN

Measure Date Value
2019: WOODLAND CENTERS EMPLOYEE MEDICAL BENEFIT PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 130
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 132
Number of retired or separated participants receiving benefits 2019-01-01 1
Total of all active and inactive participants 2019-01-01 133
Total participants 2019-01-01 133
Number of participants with account balances 2019-01-01 0
2018: WOODLAND CENTERS EMPLOYEE MEDICAL BENEFIT PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 135
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 134
Number of retired or separated participants receiving benefits 2018-01-01 8
Total of all active and inactive participants 2018-01-01 142
2017: WOODLAND CENTERS EMPLOYEE MEDICAL BENEFIT PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 125
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 135
Total of all active and inactive participants 2017-01-01 135
2016: WOODLAND CENTERS EMPLOYEE MEDICAL BENEFIT PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 122
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 125
Total of all active and inactive participants 2016-01-01 125
2015: WOODLAND CENTERS EMPLOYEE MEDICAL BENEFIT PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 108
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 122
Total of all active and inactive participants 2015-01-01 122
2014: WOODLAND CENTERS EMPLOYEE MEDICAL BENEFIT PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 113
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 108
Total of all active and inactive participants 2014-01-01 108
2013: WOODLAND CENTERS EMPLOYEE MEDICAL BENEFIT PLAN 2013 401k membership
Total participants, beginning-of-year 2013-10-01 116
Total number of active participants reported on line 7a of the Form 5500 2013-10-01 113
Total of all active and inactive participants 2013-10-01 113
Total participants 2013-10-01 113
2012: WOODLAND CENTERS EMPLOYEE MEDICAL BENEFIT PLAN 2012 401k membership
Total participants, beginning-of-year 2012-10-01 120
Total number of active participants reported on line 7a of the Form 5500 2012-10-01 116
Total of all active and inactive participants 2012-10-01 116
Total participants 2012-10-01 116
2011: WOODLAND CENTERS EMPLOYEE MEDICAL BENEFIT PLAN 2011 401k membership
Total participants, beginning-of-year 2011-10-01 120
Total number of active participants reported on line 7a of the Form 5500 2011-10-01 120
Total of all active and inactive participants 2011-10-01 120
Total participants 2011-10-01 120
2010: WOODLAND CENTERS EMPLOYEE MEDICAL BENEFIT PLAN 2010 401k membership
Total participants, beginning-of-year 2010-10-01 122
Total number of active participants reported on line 7a of the Form 5500 2010-10-01 120
Total of all active and inactive participants 2010-10-01 120
Total participants 2010-10-01 120
2009: WOODLAND CENTERS EMPLOYEE MEDICAL BENEFIT PLAN 2009 401k membership
Total participants, beginning-of-year 2009-10-01 141
Total number of active participants reported on line 7a of the Form 5500 2009-10-01 120
Number of retired or separated participants receiving benefits 2009-10-01 2
Total of all active and inactive participants 2009-10-01 122
Total participants 2009-10-01 122

Measure	Date	Value
2019: WOODLAND CENTERS EMPLOYEE MEDICAL BENEFIT PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	130
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	132
Number of retired or separated participants receiving benefits	2019-01-01	1
Total of all active and inactive participants	2019-01-01	133
Total participants	2019-01-01	133
Number of participants with account balances	2019-01-01	0
2018: WOODLAND CENTERS EMPLOYEE MEDICAL BENEFIT PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	135
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	134
Number of retired or separated participants receiving benefits	2018-01-01	8
Total of all active and inactive participants	2018-01-01	142
2017: WOODLAND CENTERS EMPLOYEE MEDICAL BENEFIT PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	125
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	135
Total of all active and inactive participants	2017-01-01	135
2016: WOODLAND CENTERS EMPLOYEE MEDICAL BENEFIT PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	122
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	125
Total of all active and inactive participants	2016-01-01	125
2015: WOODLAND CENTERS EMPLOYEE MEDICAL BENEFIT PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	108
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	122
Total of all active and inactive participants	2015-01-01	122
2014: WOODLAND CENTERS EMPLOYEE MEDICAL BENEFIT PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	113
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	108
Total of all active and inactive participants	2014-01-01	108
2013: WOODLAND CENTERS EMPLOYEE MEDICAL BENEFIT PLAN 2013 401k membership
Total participants, beginning-of-year	2013-10-01	116
Total number of active participants reported on line 7a of the Form 5500	2013-10-01	113
Total of all active and inactive participants	2013-10-01	113
Total participants	2013-10-01	113
2012: WOODLAND CENTERS EMPLOYEE MEDICAL BENEFIT PLAN 2012 401k membership
Total participants, beginning-of-year	2012-10-01	120
Total number of active participants reported on line 7a of the Form 5500	2012-10-01	116
Total of all active and inactive participants	2012-10-01	116
Total participants	2012-10-01	116
2011: WOODLAND CENTERS EMPLOYEE MEDICAL BENEFIT PLAN 2011 401k membership
Total participants, beginning-of-year	2011-10-01	120
Total number of active participants reported on line 7a of the Form 5500	2011-10-01	120
Total of all active and inactive participants	2011-10-01	120
Total participants	2011-10-01	120
2010: WOODLAND CENTERS EMPLOYEE MEDICAL BENEFIT PLAN 2010 401k membership
Total participants, beginning-of-year	2010-10-01	122
Total number of active participants reported on line 7a of the Form 5500	2010-10-01	120
Total of all active and inactive participants	2010-10-01	120
Total participants	2010-10-01	120
2009: WOODLAND CENTERS EMPLOYEE MEDICAL BENEFIT PLAN 2009 401k membership
Total participants, beginning-of-year	2009-10-01	141
Total number of active participants reported on line 7a of the Form 5500	2009-10-01	120
Number of retired or separated participants receiving benefits	2009-10-01	2
Total of all active and inactive participants	2009-10-01	122
Total participants	2009-10-01	122

Form 5500 Responses for WOODLAND CENTERS EMPLOYEE MEDICAL BENEFIT PLAN

2019: WOODLAND CENTERS EMPLOYEE MEDICAL BENEFIT PLAN 2019 form 5500 responses
2019-01-01	Type of plan entity	Single employer plan
2019-01-01	First time form 5500 has been submitted	Yes
2019-01-01	Submission has been amended	Yes
2019-01-01	This submission is the final filing	Yes
2019-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2019-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2018: WOODLAND CENTERS EMPLOYEE MEDICAL BENEFIT PLAN 2018 form 5500 responses
2018-01-01	Type of plan entity	Single employer plan
2018-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2018-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2017: WOODLAND CENTERS EMPLOYEE MEDICAL BENEFIT PLAN 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2017-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2016: WOODLAND CENTERS EMPLOYEE MEDICAL BENEFIT PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2016-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2015: WOODLAND CENTERS EMPLOYEE MEDICAL BENEFIT PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2015-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2014: WOODLAND CENTERS EMPLOYEE MEDICAL BENEFIT PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2014-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2013: WOODLAND CENTERS EMPLOYEE MEDICAL BENEFIT PLAN 2013 form 5500 responses
2013-10-01	Type of plan entity	Single employer plan
2013-10-01	Submission has been amended	No
2013-10-01	This submission is the final filing	No
2013-10-01	This return/report is a short plan year return/report (less than 12 months)	Yes
2013-10-01	Plan is a collectively bargained plan	No
2013-10-01	Plan funding arrangement – General assets of the sponsor	Yes
2013-10-01	Plan benefit arrangement – General assets of the sponsor	Yes
2012: WOODLAND CENTERS EMPLOYEE MEDICAL BENEFIT PLAN 2012 form 5500 responses
2012-10-01	Type of plan entity	Single employer plan
2012-10-01	Submission has been amended	No
2012-10-01	This submission is the final filing	No
2012-10-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-10-01	Plan is a collectively bargained plan	No
2012-10-01	Plan funding arrangement – General assets of the sponsor	Yes
2012-10-01	Plan benefit arrangement – General assets of the sponsor	Yes
2011: WOODLAND CENTERS EMPLOYEE MEDICAL BENEFIT PLAN 2011 form 5500 responses
2011-10-01	Type of plan entity	Single employer plan
2011-10-01	Submission has been amended	No
2011-10-01	This submission is the final filing	No
2011-10-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-10-01	Plan is a collectively bargained plan	No
2011-10-01	Plan funding arrangement – General assets of the sponsor	Yes
2011-10-01	Plan benefit arrangement – General assets of the sponsor	Yes
2010: WOODLAND CENTERS EMPLOYEE MEDICAL BENEFIT PLAN 2010 form 5500 responses
2010-10-01	Type of plan entity	Single employer plan
2010-10-01	Submission has been amended	No
2010-10-01	This submission is the final filing	No
2010-10-01	This return/report is a short plan year return/report (less than 12 months)	No
2010-10-01	Plan is a collectively bargained plan	No
2010-10-01	Plan funding arrangement – General assets of the sponsor	Yes
2010-10-01	Plan benefit arrangement – General assets of the sponsor	Yes
2009: WOODLAND CENTERS EMPLOYEE MEDICAL BENEFIT PLAN 2009 form 5500 responses
2009-10-01	Type of plan entity	Single employer plan
2009-10-01	Submission has been amended	No
2009-10-01	This submission is the final filing	No
2009-10-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-10-01	Plan is a collectively bargained plan	No
2009-10-01	Plan funding arrangement – General assets of the sponsor	Yes
2009-10-01	Plan benefit arrangement – General assets of the sponsor	Yes
2008: WOODLAND CENTERS EMPLOYEE MEDICAL BENEFIT PLAN 2008 form 5500 responses
2008-10-01	Type of plan entity	Single employer plan
2008-10-01	Submission has been amended	No
2008-10-01	This submission is the final filing	No
2008-10-01	This return/report is a short plan year return/report (less than 12 months)	No
2008-10-01	Plan is a collectively bargained plan	No

Insurance Providers Used on plan

INDEPENDENCE BLUE CROSS (National Association of Insurance Commissioners NAIC id number: 93688 )

Policy contract number

AG080065

Policy instance

Insurance contract or identification number	AG080065
Number of Individuals Covered	132
Health Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

Potentially related plans

WOODLAND CENTERS, INC. 403(B) PLAN [EIN = 310840780]

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Company Name:	WOODLAND CENTERS
Employer identification number (EIN):	410810019
NAIC Classification:	621399
NAIC Description:	Offices of All Other Miscellaneous Health Practitioners