401k Plan data: BEACON MENTAL HEALTH 403(B) RETIREMENT PLAN plan

BEACON MENTAL HEALTH 403(B) RETIREMENT PLAN 401k Plan overview

Plan Name	BEACON MENTAL HEALTH 403(B) RETIREMENT PLAN
Plan identification number	001

BEACON MENTAL HEALTH 403(B) RETIREMENT 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 403(b)(1) arrangement - See Limited Pension Plan Reporting instructions for Code section 403(b)(1) arrangements for certain exempt organizations.
Code section 403(b)(7) accounts - See Limited Pension Plan Reporting instructions for Code section 403(b)(7) custodial accounts for regulated investment company stock for certain exempt organizations.
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

TRI-COUNTY MENTAL HEALTH SERVICES, INC., DBA BEACON MENTAL HEALTH has sponsored the creation of one or more 401k plans.

Company Name: TRI-COUNTY MENTAL HEALTH SERVICES, INC., DBA BEACON MENTAL HEALTH

Employer identification number (EIN): 431556416

NAIC Classification: 621420
NAIC Description: Outpatient Mental Health and Substance Abuse Centers

Form 5500 Filing Information

Submission information for form 5500 for 401k plan BEACON MENTAL HEALTH 403(B) RETIREMENT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2023-01-01
001 2022-01-01
001 2021-01-01
001 2020-01-01
001 2019-01-01
001 2018-01-01 CAROLYN WORTH 2019-05-01 CAROLYN WORTH 2019-05-01
001 2017-01-01 CAROLYN WORTH 2018-02-16 CAROLYN WORTH 2018-02-16
001 2016-01-01 CAROLYN WORTH 2017-03-23 CAROLYN WORTH 2017-03-23
001 2015-01-01 CAROLYN WORTH 2016-03-08 CAROLYN WORTH 2016-03-08
001 2014-01-01 CAROLYN WORTH 2015-03-13 CAROLYN WORTH 2015-03-13
001 2013-01-01 SUSIE SCHNEIDER 2014-02-24 SUSIE SCHNEIDER 2014-02-24
001 2012-01-01 SUSIE SCHNEIDER 2013-04-26 SUSIE SCHNEIDER 2013-04-26
001 2011-01-01 SUSIE SCHNEIDER 2012-04-03 SUSIE SCHNEIDER 2012-04-03
001 2010-01-01 SUSIE SCHNEIDER 2011-06-21 SUSIE SCHNEIDER 2011-06-21

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
001	2023-01-01
001	2022-01-01
001	2021-01-01
001	2020-01-01
001	2019-01-01
001	2018-01-01	CAROLYN WORTH	2019-05-01	CAROLYN WORTH	2019-05-01
001	2017-01-01	CAROLYN WORTH	2018-02-16	CAROLYN WORTH	2018-02-16
001	2016-01-01	CAROLYN WORTH	2017-03-23	CAROLYN WORTH	2017-03-23
001	2015-01-01	CAROLYN WORTH	2016-03-08	CAROLYN WORTH	2016-03-08
001	2014-01-01	CAROLYN WORTH	2015-03-13	CAROLYN WORTH	2015-03-13
001	2013-01-01	SUSIE SCHNEIDER	2014-02-24	SUSIE SCHNEIDER	2014-02-24
001	2012-01-01	SUSIE SCHNEIDER	2013-04-26	SUSIE SCHNEIDER	2013-04-26
001	2011-01-01	SUSIE SCHNEIDER	2012-04-03	SUSIE SCHNEIDER	2012-04-03
001	2010-01-01	SUSIE SCHNEIDER	2011-06-21	SUSIE SCHNEIDER	2011-06-21

Plan Statistics for BEACON MENTAL HEALTH 403(B) RETIREMENT PLAN

401k plan membership statisitcs for BEACON MENTAL HEALTH 403(B) RETIREMENT PLAN

Measure Date Value
2023: BEACON MENTAL HEALTH 403(B) RETIREMENT PLAN 2023 401k membership
Total participants, beginning-of-year 2023-01-01 188
Total number of active participants reported on line 7a of the Form 5500 2023-01-01 185
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 22
Total of all active and inactive participants 2023-01-01 207
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2023-01-01 0
Total participants 2023-01-01 207
Number of participants with account balances 2023-01-01 123
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2023-01-01 39
2022: BEACON MENTAL HEALTH 403(B) RETIREMENT PLAN 2022 401k membership
Total participants, beginning-of-year 2022-01-01 173
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 169
Number of retired or separated participants receiving benefits 2022-01-01 0
Number of other retired or separated participants entitled to future benefits 2022-01-01 17
Total of all active and inactive participants 2022-01-01 186
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2022-01-01 2
Total participants 2022-01-01 188
Number of participants with account balances 2022-01-01 117
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2022-01-01 0
2021: BEACON MENTAL HEALTH 403(B) RETIREMENT PLAN 2021 401k membership
Total participants, beginning-of-year 2021-01-01 164
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 148
Number of retired or separated participants receiving benefits 2021-01-01 0
Number of other retired or separated participants entitled to future benefits 2021-01-01 18
Total of all active and inactive participants 2021-01-01 166
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2021-01-01 2
Total participants 2021-01-01 168
Number of participants with account balances 2021-01-01 108
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2021-01-01 9
2020: BEACON MENTAL HEALTH 403(B) RETIREMENT PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 147
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 144
Number of retired or separated participants receiving benefits 2020-01-01 0
Number of other retired or separated participants entitled to future benefits 2020-01-01 13
Total of all active and inactive participants 2020-01-01 157
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2020-01-01 2
Total participants 2020-01-01 159
Number of participants with account balances 2020-01-01 103
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-01-01 2
2019: BEACON MENTAL HEALTH 403(B) RETIREMENT PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 129
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 130
Number of retired or separated participants receiving benefits 2019-01-01 0
Number of other retired or separated participants entitled to future benefits 2019-01-01 12
Total of all active and inactive participants 2019-01-01 142
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-01-01 2
Total participants 2019-01-01 144
Number of participants with account balances 2019-01-01 98
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-01-01 6

Measure	Date	Value
2023: BEACON MENTAL HEALTH 403(B) RETIREMENT PLAN 2023 401k membership
Total participants, beginning-of-year	2023-01-01	188
Total number of active participants reported on line 7a of the Form 5500	2023-01-01	185
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	22
Total of all active and inactive participants	2023-01-01	207
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2023-01-01	0
Total participants	2023-01-01	207
Number of participants with account balances	2023-01-01	123
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2023-01-01	39
2022: BEACON MENTAL HEALTH 403(B) RETIREMENT PLAN 2022 401k membership
Total participants, beginning-of-year	2022-01-01	173
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	169
Number of retired or separated participants receiving benefits	2022-01-01	0
Number of other retired or separated participants entitled to future benefits	2022-01-01	17
Total of all active and inactive participants	2022-01-01	186
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2022-01-01	2
Total participants	2022-01-01	188
Number of participants with account balances	2022-01-01	117
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2022-01-01	0
2021: BEACON MENTAL HEALTH 403(B) RETIREMENT PLAN 2021 401k membership
Total participants, beginning-of-year	2021-01-01	164
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	148
Number of retired or separated participants receiving benefits	2021-01-01	0
Number of other retired or separated participants entitled to future benefits	2021-01-01	18
Total of all active and inactive participants	2021-01-01	166
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2021-01-01	2
Total participants	2021-01-01	168
Number of participants with account balances	2021-01-01	108
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2021-01-01	9
2020: BEACON MENTAL HEALTH 403(B) RETIREMENT PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	147
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	144
Number of retired or separated participants receiving benefits	2020-01-01	0
Number of other retired or separated participants entitled to future benefits	2020-01-01	13
Total of all active and inactive participants	2020-01-01	157
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-01-01	2
Total participants	2020-01-01	159
Number of participants with account balances	2020-01-01	103
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-01-01	2
2019: BEACON MENTAL HEALTH 403(B) RETIREMENT PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	129
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	130
Number of retired or separated participants receiving benefits	2019-01-01	0
Number of other retired or separated participants entitled to future benefits	2019-01-01	12
Total of all active and inactive participants	2019-01-01	142
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-01-01	2
Total participants	2019-01-01	144
Number of participants with account balances	2019-01-01	98
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-01-01	6

Financial Data on BEACON MENTAL HEALTH 403(B) RETIREMENT PLAN

Measure	Date	Value
2023 : BEACON MENTAL HEALTH 403(B) RETIREMENT PLAN 2023 401k financial data
Unrealized appreciation/depreciation of real estate assets	2023-12-31	$0
Unrealized appreciation/depreciation of other (non real estate) assets	2023-12-31	$0
Total unrealized appreciation/depreciation of assets	2023-12-31	$0
Total transfer of assets to this plan	2023-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2023-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2023-12-31	$0
Expenses. Interest paid	2023-12-31	$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-102	2023-12-31	$0
Total income from all sources (including contributions)	2023-12-31	$1,702,160
Total loss/gain on sale of assets	2023-12-31	$0
Total of all expenses incurred	2023-12-31	$1,013,275
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2023-12-31	$982,264
Expenses. Certain deemed distributions of participant loans	2023-12-31	$0
Value of total corrective distributions	2023-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2023-12-31	$718,592
Value of total assets at end of year	2023-12-31	$6,222,848
Value of total assets at beginning of year	2023-12-31	$5,533,963
Total of administrative expenses incurred including professional, contract, advisory and management fees	2023-12-31	$31,011
Total income from rents	2023-12-31	$0
Total interest from all sources	2023-12-31	$2,553
Total dividends received (eg from common stock, registered investment company shares)	2023-12-31	$177,703
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2023-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2023-12-31	$177,703
Assets. Real estate other than employer real property at end of year	2023-12-31	$0
Assets. Real estate other than employer real property at beginning of year	2023-12-31	$0
Assets. Corporate prefeered stocks other than exployer securities at end of year	2023-12-31	$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year	2023-12-31	$0
Was this plan covered by a fidelity bond	2023-12-31	Yes
Value of fidelity bond cover	2023-12-31	$500,000
If this is an individual account plan, was there a blackout period	2023-12-31	Yes
Were there any nonexempt tranactions with any party-in-interest	2023-12-31	No
Contributions received from participants	2023-12-31	$532,398
Participant contributions at end of year	2023-12-31	$21,966
Participant contributions at beginning of year	2023-12-31	$12,035
Participant contributions at end of year	2023-12-31	$0
Participant contributions at beginning of year	2023-12-31	$0
Assets. Other investments not covered elsewhere at end of year	2023-12-31	$0
Assets. Other investments not covered elsewhere at beginning of year	2023-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2023-12-31	$606
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2023-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at end of year	2023-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2023-12-31	$0
Assets. Loans (other than to participants) at end of year	2023-12-31	$0
Assets. Loans (other than to participants) at beginning of year	2023-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2023-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2023-12-31	$0
Other income not declared elsewhere	2023-12-31	$7,668
Administrative expenses (other) incurred	2023-12-31	$0
Total non interest bearing cash at end of year	2023-12-31	$0
Total non interest bearing cash at beginning of year	2023-12-31	$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2023-12-31	No
Income. Non cash contributions	2023-12-31	$0
Value of net income/loss	2023-12-31	$688,885
Value of net assets at end of year (total assets less liabilities)	2023-12-31	$6,222,848
Value of net assets at beginning of year (total assets less liabilities)	2023-12-31	$5,533,963
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2023-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2023-12-31	No
Were any leases to which the plan was party in default or uncollectible	2023-12-31	No
Assets. partnership/joint venture interests at end of year	2023-12-31	$0
Assets. partnership/joint venture interests at beginning of year	2023-12-31	$0
Investment advisory and management fees	2023-12-31	$0
Value of interest in registered invesment companies (eg mutual funds) at end of year	2023-12-31	$6,033,840
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2023-12-31	$5,385,984
Interest on participant loans	2023-12-31	$838
Income. Interest from loans (other than to participants)	2023-12-31	$0
Interest earned on other investments	2023-12-31	$1,715
Income. Interest from US Government securities	2023-12-31	$0
Income. Interest from corporate debt instruments	2023-12-31	$0
Value of interest in master investment trust accounts at end of year	2023-12-31	$0
Value of interest in master investment trust accounts at beginning of year	2023-12-31	$0
Value of interest in common/collective trusts at end of year	2023-12-31	$0
Value of interest in common/collective trusts at beginning of year	2023-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2023-12-31	$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2023-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2023-12-31	$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2023-12-31	$0
Assets. Value of investments in 103.12 investment entities at end of year	2023-12-31	$0
Assets. Value of investments in 103.12 investment entities at beginning of year	2023-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2023-12-31	$167,042
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2023-12-31	$135,944
Expenses. Payments to insurance carriers foe the provision of benefits	2023-12-31	$0
Asset value of US Government securities at end of year	2023-12-31	$0
Asset value of US Government securities at beginning of year	2023-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2023-12-31	$795,644
Net investment gain/loss from pooled separate accounts	2023-12-31	$0
Net investment gain or loss from common/collective trusts	2023-12-31	$0
Net gain/loss from 103.12 investment entities	2023-12-31	$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2023-12-31	No
Was there a failure to transmit to the plan any participant contributions	2023-12-31	No
Has the plan failed to provide any benefit when due under the plan	2023-12-31	No
Assets. Invements in employer securities at end of year	2023-12-31	$0
Assets. Invements in employer securities at beginning of year	2023-12-31	$0
Assets. Value of employer real property at end of year	2023-12-31	$0
Assets. Value of employer real property at beginning of year	2023-12-31	$0
Contributions received in cash from employer	2023-12-31	$185,588
Employer contributions (assets) at end of year	2023-12-31	$0
Employer contributions (assets) at beginning of year	2023-12-31	$0
Income. Dividends from preferred stock	2023-12-31	$0
Income. Dividends from common stock	2023-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2023-12-31	$982,264
Asset. Corporate debt instrument preferred debt at end of year	2023-12-31	$0
Asset. Corporate debt instrument preferred debt at beginning of year	2023-12-31	$0
Asset. Corporate debt instrument debt (other) at end of year	2023-12-31	$0
Asset. Corporate debt instrument debt (other) at beginning of year	2023-12-31	$0
Contract administrator fees	2023-12-31	$31,011
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2023-12-31	Yes
Assets. Corporate common stocks other than exployer securities at end of year	2023-12-31	$0
Assets. Corporate common stocks other than exployer securities at beginning of year	2023-12-31	$0
Liabilities. Value of benefit claims payable at end of year	2023-12-31	$0
Liabilities. Value of benefit claims payable at beginning of year	2023-12-31	$0
Assets. Value of buildings and other operty used in plan operation at end of year	2023-12-31	$0
Assets. Value of buildings and other operty used in plan operation at beginning of year	2023-12-31	$0
Did the plan have assets held for investment	2023-12-31	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	2023-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2023-12-31	No
Aggregate proceeds on sale of assets	2023-12-31	$0
Aggregate carrying amount (costs) on sale of assets	2023-12-31	$0
Liabilities. Value of acquisition indebtedness at end of year	2023-12-31	$0
Liabilities. Value of acquisition indebtedness at beginning of year	2023-12-31	$0
Opinion of an independent qualified public accountant for this plan	2023-12-31	Unqualified
Accountancy firm name	2023-12-31	PICKETT, CHANEY & MCMULLEN LLP
Accountancy firm EIN	2023-12-31	481246310
2022 : BEACON MENTAL HEALTH 403(B) RETIREMENT PLAN 2022 401k financial data
Total unrealized appreciation/depreciation of assets	2022-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2022-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2022-12-31	$0
Total income from all sources (including contributions)	2022-12-31	$-476,361
Total loss/gain on sale of assets	2022-12-31	$0
Total of all expenses incurred	2022-12-31	$250,710
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2022-12-31	$226,035
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2022-12-31	$686,745
Value of total assets at end of year	2022-12-31	$5,533,963
Value of total assets at beginning of year	2022-12-31	$6,261,034
Total of administrative expenses incurred including professional, contract, advisory and management fees	2022-12-31	$24,675
Total interest from all sources	2022-12-31	$1,886
Total dividends received (eg from common stock, registered investment company shares)	2022-12-31	$89,425
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2022-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2022-12-31	$89,425
Was this plan covered by a fidelity bond	2022-12-31	Yes
Value of fidelity bond cover	2022-12-31	$500,000
If this is an individual account plan, was there a blackout period	2022-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2022-12-31	No
Contributions received from participants	2022-12-31	$492,578
Participant contributions at end of year	2022-12-31	$12,035
Participant contributions at beginning of year	2022-12-31	$14,815
Income. Received or receivable in cash from other sources (including rollovers)	2022-12-31	$23,303
Other income not declared elsewhere	2022-12-31	$2
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2022-12-31	No
Value of net income/loss	2022-12-31	$-727,071
Value of net assets at end of year (total assets less liabilities)	2022-12-31	$5,533,963
Value of net assets at beginning of year (total assets less liabilities)	2022-12-31	$6,261,034
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2022-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2022-12-31	No
Were any leases to which the plan was party in default or uncollectible	2022-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2022-12-31	$5,385,984
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2022-12-31	$6,126,151
Interest on participant loans	2022-12-31	$747
Interest earned on other investments	2022-12-31	$1,139
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2022-12-31	$135,944
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2022-12-31	$120,068
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2022-12-31	$-1,254,419
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2022-12-31	No
Was there a failure to transmit to the plan any participant contributions	2022-12-31	No
Has the plan failed to provide any benefit when due under the plan	2022-12-31	No
Contributions received in cash from employer	2022-12-31	$170,864
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2022-12-31	$226,035
Contract administrator fees	2022-12-31	$24,675
Did the plan have assets held for investment	2022-12-31	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	2022-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2022-12-31	No
Opinion of an independent qualified public accountant for this plan	2022-12-31	Unqualified
Accountancy firm name	2022-12-31	PICKETT, CHANEY & MCMULLEN, LLP
Accountancy firm EIN	2022-12-31	481246310
2021 : BEACON MENTAL HEALTH 403(B) RETIREMENT PLAN 2021 401k financial data
Total unrealized appreciation/depreciation of assets	2021-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-12-31	$0
Total income from all sources (including contributions)	2021-12-31	$1,391,027
Total loss/gain on sale of assets	2021-12-31	$0
Total of all expenses incurred	2021-12-31	$1,090,337
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2021-12-31	$1,062,114
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2021-12-31	$644,963
Value of total assets at end of year	2021-12-31	$6,261,034
Value of total assets at beginning of year	2021-12-31	$5,960,344
Total of administrative expenses incurred including professional, contract, advisory and management fees	2021-12-31	$28,223
Total interest from all sources	2021-12-31	$6,927
Total dividends received (eg from common stock, registered investment company shares)	2021-12-31	$120,284
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2021-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2021-12-31	$120,284
Was this plan covered by a fidelity bond	2021-12-31	Yes
Value of fidelity bond cover	2021-12-31	$500,000
If this is an individual account plan, was there a blackout period	2021-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2021-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2021-12-31	No
Contributions received from participants	2021-12-31	$462,599
Participant contributions at end of year	2021-12-31	$14,815
Participant contributions at beginning of year	2021-12-31	$8,507
Income. Received or receivable in cash from other sources (including rollovers)	2021-12-31	$11,451
Other income not declared elsewhere	2021-12-31	$22
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2021-12-31	No
Value of net income/loss	2021-12-31	$300,690
Value of net assets at end of year (total assets less liabilities)	2021-12-31	$6,261,034
Value of net assets at beginning of year (total assets less liabilities)	2021-12-31	$5,960,344
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2021-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2021-12-31	No
Were any leases to which the plan was party in default or uncollectible	2021-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2021-12-31	$6,126,151
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2021-12-31	$4,855,126
Interest on participant loans	2021-12-31	$400
Interest earned on other investments	2021-12-31	$6,527
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2021-12-31	$120,068
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2021-12-31	$1,096,225
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2021-12-31	$618,831
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2021-12-31	No
Was there a failure to transmit to the plan any participant contributions	2021-12-31	No
Has the plan failed to provide any benefit when due under the plan	2021-12-31	No
Contributions received in cash from employer	2021-12-31	$170,913
Employer contributions (assets) at beginning of year	2021-12-31	$486
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2021-12-31	$1,062,114
Contract administrator fees	2021-12-31	$28,223
Did the plan have assets held for investment	2021-12-31	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	2021-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2021-12-31	No
Opinion of an independent qualified public accountant for this plan	2021-12-31	Unqualified
Accountancy firm name	2021-12-31	PICKETT, CHANEY & MCMULLEN LLP
Accountancy firm EIN	2021-12-31	481246310
2020 : BEACON MENTAL HEALTH 403(B) RETIREMENT PLAN 2020 401k financial data
Unrealized appreciation/depreciation of real estate assets	2020-12-31	$0
Unrealized appreciation/depreciation of other (non real estate) assets	2020-12-31	$0
Total unrealized appreciation/depreciation of assets	2020-12-31	$0
Total transfer of assets to this plan	2020-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-12-31	$0
Total income from all sources (including contributions)	2020-12-31	$1,248,133
Total loss/gain on sale of assets	2020-12-31	$0
Total of all expenses incurred	2020-12-31	$190,435
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2020-12-31	$167,525
Expenses. Certain deemed distributions of participant loans	2020-12-31	$0
Value of total corrective distributions	2020-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2020-12-31	$578,384
Value of total assets at end of year	2020-12-31	$5,960,344
Value of total assets at beginning of year	2020-12-31	$4,902,646
Total of administrative expenses incurred including professional, contract, advisory and management fees	2020-12-31	$22,910
Total income from rents	2020-12-31	$0
Total interest from all sources	2020-12-31	$11,833
Total dividends received (eg from common stock, registered investment company shares)	2020-12-31	$69,448
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2020-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2020-12-31	$69,448
Administrative expenses professional fees incurred	2020-12-31	$0
Was this plan covered by a fidelity bond	2020-12-31	Yes
Value of fidelity bond cover	2020-12-31	$500,000
If this is an individual account plan, was there a blackout period	2020-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2020-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2020-12-31	No
Amount of non-exempt transactions with any party-in-interest	2020-12-31	$0
Contributions received from participants	2020-12-31	$401,208
Participant contributions at end of year	2020-12-31	$8,507
Participant contributions at beginning of year	2020-12-31	$7,235
Participant contributions at end of year	2020-12-31	$0
Participant contributions at beginning of year	2020-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2020-12-31	$25,539
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2020-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at end of year	2020-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2020-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2020-12-31	$0
Other income not declared elsewhere	2020-12-31	$15
Administrative expenses (other) incurred	2020-12-31	$0
Liabilities. Value of operating payables at beginning of year	2020-12-31	$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2020-12-31	No
Value of net income/loss	2020-12-31	$1,057,698
Value of net assets at end of year (total assets less liabilities)	2020-12-31	$5,960,344
Value of net assets at beginning of year (total assets less liabilities)	2020-12-31	$4,902,646
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2020-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2020-12-31	No
Amount of loans by the plan or fixed income obligations due to the plan which were in default/classified-as-uncollectible as of the close of the plan year	2020-12-31	$0
Were any leases to which the plan was party in default or uncollectible	2020-12-31	No
Amount of leases to which the plan was a party which were in default/classified-as-uncollectible during the year	2020-12-31	$0
Investment advisory and management fees	2020-12-31	$0
Value of interest in registered invesment companies (eg mutual funds) at end of year	2020-12-31	$4,855,126
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2020-12-31	$4,795,702
Interest on participant loans	2020-12-31	$527
Income. Interest from loans (other than to participants)	2020-12-31	$0
Interest earned on other investments	2020-12-31	$11,306
Income. Interest from US Government securities	2020-12-31	$0
Income. Interest from corporate debt instruments	2020-12-31	$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2020-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2020-12-31	$1,096,225
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2020-12-31	$99,709
Expenses. Payments to insurance carriers foe the provision of benefits	2020-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2020-12-31	$588,453
Net investment gain/loss from pooled separate accounts	2020-12-31	$0
Net investment gain or loss from common/collective trusts	2020-12-31	$0
Net gain/loss from 103.12 investment entities	2020-12-31	$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2020-12-31	No
Was there a failure to transmit to the plan any participant contributions	2020-12-31	No
Has the plan failed to provide any benefit when due under the plan	2020-12-31	No
Contributions received in cash from employer	2020-12-31	$151,637
Employer contributions (assets) at end of year	2020-12-31	$486
Employer contributions (assets) at beginning of year	2020-12-31	$0
Income. Dividends from preferred stock	2020-12-31	$0
Income. Dividends from common stock	2020-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2020-12-31	$167,525
Contract administrator fees	2020-12-31	$22,910
Liabilities. Value of benefit claims payable at beginning of year	2020-12-31	$0
Did the plan have assets held for investment	2020-12-31	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	2020-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2020-12-31	No
Aggregate proceeds on sale of assets	2020-12-31	$0
Aggregate carrying amount (costs) on sale of assets	2020-12-31	$0
Liabilities. Value of acquisition indebtedness at beginning of year	2020-12-31	$0
Opinion of an independent qualified public accountant for this plan	2020-12-31	Disclaimer
Accountancy firm name	2020-12-31	PICKETT, CHANEY & MCMULLEN, LLP
Accountancy firm EIN	2020-12-31	481246310
2019 : BEACON MENTAL HEALTH 403(B) RETIREMENT PLAN 2019 401k financial data
Unrealized appreciation/depreciation of real estate assets	2019-12-31	$0
Unrealized appreciation/depreciation of other (non real estate) assets	2019-12-31	$0
Total unrealized appreciation/depreciation of assets	2019-12-31	$0
Total transfer of assets to this plan	2019-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$0
Total income from all sources (including contributions)	2019-12-31	$1,393,730
Total loss/gain on sale of assets	2019-12-31	$0
Total of all expenses incurred	2019-12-31	$338,965
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$315,691
Expenses. Certain deemed distributions of participant loans	2019-12-31	$0
Value of total corrective distributions	2019-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$519,394
Value of total assets at end of year	2019-12-31	$4,902,646
Value of total assets at beginning of year	2019-12-31	$3,847,881
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$23,274
Total income from rents	2019-12-31	$0
Total interest from all sources	2019-12-31	$1,560
Total dividends received (eg from common stock, registered investment company shares)	2019-12-31	$89,098
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2019-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2019-12-31	$89,098
Administrative expenses professional fees incurred	2019-12-31	$0
Was this plan covered by a fidelity bond	2019-12-31	Yes
Value of fidelity bond cover	2019-12-31	$500,000
If this is an individual account plan, was there a blackout period	2019-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2019-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2019-12-31	No
Amount of non-exempt transactions with any party-in-interest	2019-12-31	$0
Contributions received from participants	2019-12-31	$331,401
Participant contributions at end of year	2019-12-31	$7,235
Participant contributions at beginning of year	2019-12-31	$11,023
Participant contributions at end of year	2019-12-31	$0
Participant contributions at beginning of year	2019-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2019-12-31	$64,273
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2019-12-31	$6,500
Value of other receiveables (less allowance for doubtful accounts) at end of year	2019-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2019-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2019-12-31	$0
Other income not declared elsewhere	2019-12-31	$0
Administrative expenses (other) incurred	2019-12-31	$0
Liabilities. Value of operating payables at beginning of year	2019-12-31	$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-12-31	No
Value of net income/loss	2019-12-31	$1,054,765
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$4,902,646
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$3,847,881
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2019-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2019-12-31	No
Amount of loans by the plan or fixed income obligations due to the plan which were in default/classified-as-uncollectible as of the close of the plan year	2019-12-31	$0
Were any leases to which the plan was party in default or uncollectible	2019-12-31	No
Amount of leases to which the plan was a party which were in default/classified-as-uncollectible during the year	2019-12-31	$0
Investment advisory and management fees	2019-12-31	$0
Value of interest in registered invesment companies (eg mutual funds) at end of year	2019-12-31	$4,795,702
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2019-12-31	$3,747,198
Interest on participant loans	2019-12-31	$506
Income. Interest from loans (other than to participants)	2019-12-31	$0
Interest earned on other investments	2019-12-31	$1,054
Income. Interest from US Government securities	2019-12-31	$0
Income. Interest from corporate debt instruments	2019-12-31	$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2019-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2019-12-31	$99,709
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2019-12-31	$89,322
Expenses. Payments to insurance carriers foe the provision of benefits	2019-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2019-12-31	$783,678
Net investment gain/loss from pooled separate accounts	2019-12-31	$0
Net investment gain or loss from common/collective trusts	2019-12-31	$0
Net gain/loss from 103.12 investment entities	2019-12-31	$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2019-12-31	No
Was there a failure to transmit to the plan any participant contributions	2019-12-31	No
Has the plan failed to provide any benefit when due under the plan	2019-12-31	No
Contributions received in cash from employer	2019-12-31	$123,720
Employer contributions (assets) at end of year	2019-12-31	$0
Employer contributions (assets) at beginning of year	2019-12-31	$338
Income. Dividends from preferred stock	2019-12-31	$0
Income. Dividends from common stock	2019-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-31	$309,191
Contract administrator fees	2019-12-31	$23,274
Liabilities. Value of benefit claims payable at beginning of year	2019-12-31	$0
Did the plan have assets held for investment	2019-12-31	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	2019-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2019-12-31	No
Aggregate proceeds on sale of assets	2019-12-31	$0
Aggregate carrying amount (costs) on sale of assets	2019-12-31	$0
Liabilities. Value of acquisition indebtedness at beginning of year	2019-12-31	$0
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2019-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2019-12-31	Disclaimer
Accountancy firm name	2019-12-31	PICKETT, CHANEY & MCMULLEN, LLP
Accountancy firm EIN	2019-12-31	481246310

Form 5500 Responses for BEACON MENTAL HEALTH 403(B) RETIREMENT PLAN

2023: BEACON MENTAL HEALTH 403(B) RETIREMENT PLAN 2023 form 5500 responses
2023-01-01	Type of plan entity	Single employer plan
2023-01-01	Submission has been amended	No
2023-01-01	This submission is the final filing	No
2023-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2023-01-01	Plan is a collectively bargained plan	No
2023-01-01	Plan funding arrangement – Insurance	Yes
2023-01-01	Plan funding arrangement – Trust	Yes
2023-01-01	Plan benefit arrangement – Insurance	Yes
2023-01-01	Plan benefit arrangement - Trust	Yes
2022: BEACON MENTAL HEALTH 403(B) RETIREMENT PLAN 2022 form 5500 responses
2022-01-01	Type of plan entity	Single employer plan
2022-01-01	This submission is the final filing	No
2022-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2022-01-01	Plan is a collectively bargained plan	No
2022-01-01	Plan funding arrangement – Insurance	Yes
2022-01-01	Plan funding arrangement – Trust	Yes
2022-01-01	Plan benefit arrangement – Insurance	Yes
2022-01-01	Plan benefit arrangement - Trust	Yes
2021: BEACON MENTAL HEALTH 403(B) RETIREMENT PLAN 2021 form 5500 responses
2021-01-01	Type of plan entity	Single employer plan
2021-01-01	This submission is the final filing	No
2021-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2021-01-01	Plan is a collectively bargained plan	No
2021-01-01	Plan funding arrangement – Insurance	Yes
2021-01-01	Plan funding arrangement – Trust	Yes
2021-01-01	Plan benefit arrangement – Insurance	Yes
2021-01-01	Plan benefit arrangement - Trust	Yes
2020: BEACON MENTAL HEALTH 403(B) RETIREMENT PLAN 2020 form 5500 responses
2020-01-01	Type of plan entity	Single employer plan
2020-01-01	This submission is the final filing	No
2020-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2020-01-01	Plan is a collectively bargained plan	No
2020-01-01	Plan funding arrangement – Insurance	Yes
2020-01-01	Plan funding arrangement – Trust	Yes
2020-01-01	Plan benefit arrangement – Insurance	Yes
2020-01-01	Plan benefit arrangement - Trust	Yes
2019: BEACON MENTAL HEALTH 403(B) RETIREMENT PLAN 2019 form 5500 responses
2019-01-01	Type of plan entity	Single employer plan
2019-01-01	This submission is the final filing	No
2019-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2019-01-01	Plan is a collectively bargained plan	No
2019-01-01	Plan funding arrangement – Insurance	Yes
2019-01-01	Plan funding arrangement – Trust	Yes
2019-01-01	Plan benefit arrangement – Insurance	Yes
2019-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

FIRST GREAT WEST LIFE INSURANCE & ANNUITY CO (National Association of Insurance Commissioners NAIC id number: 60214 )

Policy contract number

520886-01

Policy instance

Insurance contract or identification number	520886-01
Number of Individuals Covered	7
Insurance policy start date	2023-12-06
Insurance policy end date	2023-12-31
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
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
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61272 )

Policy contract number

613953

Policy instance

Insurance contract or identification number	613953
Number of Individuals Covered	0
Insurance policy start date	2023-01-01
Insurance policy end date	2023-12-31
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
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
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )

Policy contract number

613953

Policy instance

Insurance contract or identification number	613953
Number of Individuals Covered	188
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
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

PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )

Policy contract number

613953

Policy instance

Insurance contract or identification number	613953
Number of Individuals Covered	168
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
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

PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )

Policy contract number

613953

Policy instance

Insurance contract or identification number	613953
Number of Individuals Covered	159
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
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

PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )

Policy contract number

613953

Policy instance

Insurance contract or identification number	613953
Number of Individuals Covered	144
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
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

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Company Name:	TRI-COUNTY MENTAL HEALTH SERVICES, INC., DBA BEACON MENTAL HEALTH
Employer identification number (EIN):	431556416
NAIC Classification:	621420
NAIC Description:	Outpatient Mental Health and Substance Abuse Centers