401k Plan data: COMMUNITY HIGHERED WELFARE PLAN plan

COMMUNITY HIGHERED WELFARE PLAN 401k Plan overview

Plan Name	COMMUNITY HIGHERED WELFARE PLAN
Plan identification number	501

COMMUNITY HIGHERED WELFARE PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) Life insurance Dental Vision Temporary disability (accident and sickness) Death benefits (include travel accident but not life insurance) Other welfare benefit cover Unfunded, fully insured, or combination unfunded/insured welfare plan that will not file a Form 5500 for next plan year pursuant to 29 CFR 2520.104-20.

401k Sponsoring company profile

COMMUNITY HIGHERED has sponsored the creation of one or more 401k plans.

Company Name: COMMUNITY HIGHERED

Employer identification number (EIN): 472654761

NAIC Classification: 611000

Form 5500 Filing Information

Submission information for form 5500 for 401k plan COMMUNITY HIGHERED WELFARE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2023-01-01 PALLAVI AGARWAL 2024-04-16
501 2022-01-01 PALLAVI AGARWAL 2023-05-22
501 2021-01-01 PALLAVI AGARWAL 2022-06-17
501 2020-01-01 PALLAVI AGARWAL 2021-04-12
501 2020-01-01 PALLAVI AGARWAL 2021-09-07
501 2019-01-01 PALLAVI AGARWAL 2020-04-30
501 2019-01-01 PALLAVI AGARWAL 2022-06-20
501 2018-01-01
501 2017-01-01 LORI RUSSELL
501 2016-01-01 LORI RUSSELL
501 2015-01-01 PALLAVI AGARWAL PALLAVI AGARWAL 2016-09-16

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
501	2023-01-01	PALLAVI AGARWAL	2024-04-16
501	2022-01-01	PALLAVI AGARWAL	2023-05-22
501	2021-01-01	PALLAVI AGARWAL	2022-06-17
501	2020-01-01	PALLAVI AGARWAL	2021-04-12
501	2020-01-01	PALLAVI AGARWAL	2021-09-07
501	2019-01-01	PALLAVI AGARWAL	2020-04-30
501	2019-01-01	PALLAVI AGARWAL	2022-06-20
501	2018-01-01
501	2017-01-01	LORI RUSSELL
501	2016-01-01	LORI RUSSELL
501	2015-01-01	PALLAVI AGARWAL		PALLAVI AGARWAL	2016-09-16

Form 5500 Responses for COMMUNITY HIGHERED WELFARE PLAN

2023: COMMUNITY HIGHERED WELFARE PLAN 2023 form 5500 responses
2023-01-01	Type of plan entity	Single employer plan
2023-01-01	Plan funding arrangement – Insurance	Yes
2023-01-01	Plan benefit arrangement – Insurance	Yes
2022: COMMUNITY HIGHERED WELFARE PLAN 2022 form 5500 responses
2022-01-01	Type of plan entity	Single employer plan
2022-01-01	Plan funding arrangement – Insurance	Yes
2022-01-01	Plan benefit arrangement – Insurance	Yes
2021: COMMUNITY HIGHERED WELFARE PLAN 2021 form 5500 responses
2021-01-01	Type of plan entity	Single employer plan
2021-01-01	Plan funding arrangement – Insurance	Yes
2021-01-01	Plan benefit arrangement – Insurance	Yes
2020: COMMUNITY HIGHERED WELFARE PLAN 2020 form 5500 responses
2020-01-01	Type of plan entity	Single employer plan
2020-01-01	Submission has been amended	Yes
2020-01-01	Plan funding arrangement – Insurance	Yes
2020-01-01	Plan benefit arrangement – Insurance	Yes
2019: COMMUNITY HIGHERED WELFARE PLAN 2019 form 5500 responses
2019-01-01	Type of plan entity	Single employer plan
2019-01-01	Submission has been amended	Yes
2019-01-01	Plan funding arrangement – Insurance	Yes
2019-01-01	Plan benefit arrangement – Insurance	Yes
2018: COMMUNITY HIGHERED WELFARE PLAN 2018 form 5500 responses
2018-01-01	Type of plan entity	Single employer plan
2018-01-01	Plan funding arrangement – Insurance	Yes
2018-01-01	Plan benefit arrangement – Insurance	Yes
2017: COMMUNITY HIGHERED WELFARE PLAN 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	Submission has been amended	No
2017-01-01	This submission is the final filing	No
2017-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2017-01-01	Plan is a collectively bargained plan	No
2017-01-01	Plan funding arrangement – Insurance	Yes
2017-01-01	Plan benefit arrangement – Insurance	Yes
2016: COMMUNITY HIGHERED WELFARE 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
2015: COMMUNITY HIGHERED WELFARE PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	First time form 5500 has been submitted	Yes
2015-01-01	Submission has been amended	No
2015-01-01	This submission is the final filing	No
2015-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-01-01	Plan is a collectively bargained plan	No
2015-01-01	Plan funding arrangement – Insurance	Yes
2015-01-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

DELTA DENTAL (National Association of Insurance Commissioners NAIC id number: 53937 )

Policy contract number

1428

Policy instance

Insurance contract or identification number	1428
Number of Individuals Covered	67
Insurance policy start date	2023-01-01
Insurance policy end date	2023-12-31
Total amount of commissions paid to insurance broker	USD $2,326
Total amount of fees paid to insurance company	USD $0
Dental Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

COMMUNITY CARE (National Association of Insurance Commissioners NAIC id number: 10001 )

Policy contract number

C01339

Policy instance

Insurance contract or identification number	C01339
Number of Individuals Covered	88
Insurance policy start date	2023-01-01
Insurance policy end date	2023-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $23,821
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $427,021
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )

Policy contract number

5949801

Policy instance

Insurance contract or identification number	5949801
Number of Individuals Covered	186
Insurance policy start date	2023-01-01
Insurance policy end date	2023-12-31
Total amount of commissions paid to insurance broker	USD $3,030
Total amount of fees paid to insurance company	USD $442
Vision Insurance Welfare Benefit	Yes
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to Carrier	USD $21,415
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )

Policy contract number

5949801

Policy instance

Insurance contract or identification number	5949801
Number of Individuals Covered	164
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $2,712
Total amount of fees paid to insurance company	USD $371
Vision Insurance Welfare Benefit	Yes
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to Carrier	USD $22,383
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

COMMUNITY CARE (National Association of Insurance Commissioners NAIC id number: 10001 )

Policy contract number

C01339

Policy instance

Insurance contract or identification number	C01339
Number of Individuals Covered	98
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $26,530
Total amount of fees paid to insurance company	USD $0
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $485,599
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

DELTA DENTAL (National Association of Insurance Commissioners NAIC id number: 53937 )

Policy contract number

1428

Policy instance

Insurance contract or identification number	1428
Number of Individuals Covered	72
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $2,422
Total amount of fees paid to insurance company	USD $0
Dental Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )

Policy contract number

582211

Policy instance

COMMUNITY CARE (National Association of Insurance Commissioners NAIC id number: 10001 )

Policy contract number

C01339

Policy instance

METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )

Policy contract number

5949801

Policy instance

COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60049 )

Policy contract number

E4484036

Policy instance

DELTA DENTAL (National Association of Insurance Commissioners NAIC id number: 53937 )

Policy contract number

1428

Policy instance

COMMUNITY CARE (National Association of Insurance Commissioners NAIC id number: 10001 )

Policy contract number

C01339

Policy instance

METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )

Policy contract number

5949801

Policy instance

METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )

Policy contract number

KM05949801

Policy instance

COMMUNITY CARE (National Association of Insurance Commissioners NAIC id number: 10001 )

Policy contract number

C01339

Policy instance

DELTA DENTAL (National Association of Insurance Commissioners NAIC id number: 53937 )

Policy contract number

1428

Policy instance

METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )

Policy contract number

KM05949801

Policy instance

COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60049 )

Policy contract number

E4484036

Policy instance

COMMUNITY CARE (National Association of Insurance Commissioners NAIC id number: 10001 )

Policy contract number

C01339

Policy instance

DELTA DENTAL (National Association of Insurance Commissioners NAIC id number: 53937 )

Policy contract number

1428

Policy instance

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Company Name:	COMMUNITY HIGHERED
Employer identification number (EIN):	472654761
NAIC Classification:	611000