401k Plan data: FIVE COUNTY CHILD DEVELOPMENT PROGRAM, INC HEALTH AND WELFARE PLAN plan

FIVE COUNTY CHILD DEVELOPMENT PROGRAM, INC HEALTH AND WELFARE PLAN 401k Plan overview

Plan Name	FIVE COUNTY CHILD DEVELOPMENT PROGRAM, INC HEALTH AND WELFARE PLAN
Plan identification number	503

FIVE COUNTY CHILD DEVELOPMENT PROGRAM, INC HEALTH AND 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) Long-term disability cover

401k Sponsoring company profile

FIVE COUNTY CHILD DEVELOPMENT INC has sponsored the creation of one or more 401k plans.

Company Name: FIVE COUNTY CHILD DEVELOPMENT INC

Employer identification number (EIN): 640513252

NAIC Classification: 624100
NAIC Description: Individual and Family Services

Form 5500 Filing Information

Submission information for form 5500 for 401k plan FIVE COUNTY CHILD DEVELOPMENT PROGRAM, INC HEALTH AND WELFARE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
503 2019-10-01
503 2018-10-01
503 2017-10-01
503 2016-10-01 TANGELIA REESE
503 2015-10-01 TANGELIA REESE
503 2014-10-01 TANGELIA REESE
503 2013-10-01 TANGELIA REESE

Plan Statistics for FIVE COUNTY CHILD DEVELOPMENT PROGRAM, INC HEALTH AND WELFARE PLAN

401k plan membership statisitcs for FIVE COUNTY CHILD DEVELOPMENT PROGRAM, INC HEALTH AND WELFARE PLAN

Measure Date Value
2019: FIVE COUNTY CHILD DEVELOPMENT PROGRAM, INC HEALTH AND WELFARE PLAN 2019 401k membership
Total participants, beginning-of-year 2019-10-01 158
Total number of active participants reported on line 7a of the Form 5500 2019-10-01 131
Number of retired or separated participants receiving benefits 2019-10-01 0
Number of other retired or separated participants entitled to future benefits 2019-10-01 0
Total of all active and inactive participants 2019-10-01 131
2018: FIVE COUNTY CHILD DEVELOPMENT PROGRAM, INC HEALTH AND WELFARE PLAN 2018 401k membership
Total participants, beginning-of-year 2018-10-01 158
Total number of active participants reported on line 7a of the Form 5500 2018-10-01 158
Number of retired or separated participants receiving benefits 2018-10-01 0
Number of other retired or separated participants entitled to future benefits 2018-10-01 0
Total of all active and inactive participants 2018-10-01 158
2017: FIVE COUNTY CHILD DEVELOPMENT PROGRAM, INC HEALTH AND WELFARE PLAN 2017 401k membership
Total participants, beginning-of-year 2017-10-01 165
Total number of active participants reported on line 7a of the Form 5500 2017-10-01 158
Number of retired or separated participants receiving benefits 2017-10-01 0
Number of other retired or separated participants entitled to future benefits 2017-10-01 0
Total of all active and inactive participants 2017-10-01 158
2016: FIVE COUNTY CHILD DEVELOPMENT PROGRAM, INC HEALTH AND WELFARE PLAN 2016 401k membership
Total participants, beginning-of-year 2016-10-01 173
Total number of active participants reported on line 7a of the Form 5500 2016-10-01 165
Number of retired or separated participants receiving benefits 2016-10-01 0
Number of other retired or separated participants entitled to future benefits 2016-10-01 0
Total of all active and inactive participants 2016-10-01 165
2015: FIVE COUNTY CHILD DEVELOPMENT PROGRAM, INC HEALTH AND WELFARE PLAN 2015 401k membership
Total participants, beginning-of-year 2015-10-01 170
Total number of active participants reported on line 7a of the Form 5500 2015-10-01 173
Number of retired or separated participants receiving benefits 2015-10-01 0
Number of other retired or separated participants entitled to future benefits 2015-10-01 0
Total of all active and inactive participants 2015-10-01 173
2014: FIVE COUNTY CHILD DEVELOPMENT PROGRAM, INC HEALTH AND WELFARE PLAN 2014 401k membership
Total participants, beginning-of-year 2014-10-01 170
Total number of active participants reported on line 7a of the Form 5500 2014-10-01 170
Number of retired or separated participants receiving benefits 2014-10-01 0
Number of other retired or separated participants entitled to future benefits 2014-10-01 0
Total of all active and inactive participants 2014-10-01 170
2013: FIVE COUNTY CHILD DEVELOPMENT PROGRAM, INC HEALTH AND WELFARE PLAN 2013 401k membership
Total participants, beginning-of-year 2013-10-01 170
Total number of active participants reported on line 7a of the Form 5500 2013-10-01 170
Total of all active and inactive participants 2013-10-01 170

Measure	Date	Value
2019: FIVE COUNTY CHILD DEVELOPMENT PROGRAM, INC HEALTH AND WELFARE PLAN 2019 401k membership
Total participants, beginning-of-year	2019-10-01	158
Total number of active participants reported on line 7a of the Form 5500	2019-10-01	131
Number of retired or separated participants receiving benefits	2019-10-01	0
Number of other retired or separated participants entitled to future benefits	2019-10-01	0
Total of all active and inactive participants	2019-10-01	131
2018: FIVE COUNTY CHILD DEVELOPMENT PROGRAM, INC HEALTH AND WELFARE PLAN 2018 401k membership
Total participants, beginning-of-year	2018-10-01	158
Total number of active participants reported on line 7a of the Form 5500	2018-10-01	158
Number of retired or separated participants receiving benefits	2018-10-01	0
Number of other retired or separated participants entitled to future benefits	2018-10-01	0
Total of all active and inactive participants	2018-10-01	158
2017: FIVE COUNTY CHILD DEVELOPMENT PROGRAM, INC HEALTH AND WELFARE PLAN 2017 401k membership
Total participants, beginning-of-year	2017-10-01	165
Total number of active participants reported on line 7a of the Form 5500	2017-10-01	158
Number of retired or separated participants receiving benefits	2017-10-01	0
Number of other retired or separated participants entitled to future benefits	2017-10-01	0
Total of all active and inactive participants	2017-10-01	158
2016: FIVE COUNTY CHILD DEVELOPMENT PROGRAM, INC HEALTH AND WELFARE PLAN 2016 401k membership
Total participants, beginning-of-year	2016-10-01	173
Total number of active participants reported on line 7a of the Form 5500	2016-10-01	165
Number of retired or separated participants receiving benefits	2016-10-01	0
Number of other retired or separated participants entitled to future benefits	2016-10-01	0
Total of all active and inactive participants	2016-10-01	165
2015: FIVE COUNTY CHILD DEVELOPMENT PROGRAM, INC HEALTH AND WELFARE PLAN 2015 401k membership
Total participants, beginning-of-year	2015-10-01	170
Total number of active participants reported on line 7a of the Form 5500	2015-10-01	173
Number of retired or separated participants receiving benefits	2015-10-01	0
Number of other retired or separated participants entitled to future benefits	2015-10-01	0
Total of all active and inactive participants	2015-10-01	173
2014: FIVE COUNTY CHILD DEVELOPMENT PROGRAM, INC HEALTH AND WELFARE PLAN 2014 401k membership
Total participants, beginning-of-year	2014-10-01	170
Total number of active participants reported on line 7a of the Form 5500	2014-10-01	170
Number of retired or separated participants receiving benefits	2014-10-01	0
Number of other retired or separated participants entitled to future benefits	2014-10-01	0
Total of all active and inactive participants	2014-10-01	170
2013: FIVE COUNTY CHILD DEVELOPMENT PROGRAM, INC HEALTH AND WELFARE PLAN 2013 401k membership
Total participants, beginning-of-year	2013-10-01	170
Total number of active participants reported on line 7a of the Form 5500	2013-10-01	170
Total of all active and inactive participants	2013-10-01	170

Form 5500 Responses for FIVE COUNTY CHILD DEVELOPMENT PROGRAM, INC HEALTH AND WELFARE PLAN

2019: FIVE COUNTY CHILD DEVELOPMENT PROGRAM, INC HEALTH AND WELFARE PLAN 2019 form 5500 responses
2019-10-01	Type of plan entity	Single employer plan
2019-10-01	Plan funding arrangement – Insurance	Yes
2019-10-01	Plan funding arrangement – General assets of the sponsor	Yes
2019-10-01	Plan benefit arrangement – Insurance	Yes
2019-10-01	Plan benefit arrangement – General assets of the sponsor	Yes
2018: FIVE COUNTY CHILD DEVELOPMENT PROGRAM, INC HEALTH AND WELFARE PLAN 2018 form 5500 responses
2018-10-01	Type of plan entity	Single employer plan
2018-10-01	Plan funding arrangement – Insurance	Yes
2018-10-01	Plan funding arrangement – General assets of the sponsor	Yes
2018-10-01	Plan benefit arrangement – Insurance	Yes
2018-10-01	Plan benefit arrangement – General assets of the sponsor	Yes
2017: FIVE COUNTY CHILD DEVELOPMENT PROGRAM, INC HEALTH AND WELFARE PLAN 2017 form 5500 responses
2017-10-01	Type of plan entity	Single employer plan
2017-10-01	Plan funding arrangement – Insurance	Yes
2017-10-01	Plan funding arrangement – General assets of the sponsor	Yes
2017-10-01	Plan benefit arrangement – Insurance	Yes
2017-10-01	Plan benefit arrangement – General assets of the sponsor	Yes
2016: FIVE COUNTY CHILD DEVELOPMENT PROGRAM, INC HEALTH AND WELFARE PLAN 2016 form 5500 responses
2016-10-01	Type of plan entity	Single employer plan
2016-10-01	Plan funding arrangement – Insurance	Yes
2016-10-01	Plan funding arrangement – General assets of the sponsor	Yes
2016-10-01	Plan benefit arrangement – Insurance	Yes
2016-10-01	Plan benefit arrangement – General assets of the sponsor	Yes
2015: FIVE COUNTY CHILD DEVELOPMENT PROGRAM, INC HEALTH AND WELFARE PLAN 2015 form 5500 responses
2015-10-01	Type of plan entity	Single employer plan
2015-10-01	Plan funding arrangement – Insurance	Yes
2015-10-01	Plan funding arrangement – General assets of the sponsor	Yes
2015-10-01	Plan benefit arrangement – Insurance	Yes
2015-10-01	Plan benefit arrangement – General assets of the sponsor	Yes
2014: FIVE COUNTY CHILD DEVELOPMENT PROGRAM, INC HEALTH AND WELFARE PLAN 2014 form 5500 responses
2014-10-01	Type of plan entity	Single employer plan
2014-10-01	Plan funding arrangement – Insurance	Yes
2014-10-01	Plan funding arrangement – General assets of the sponsor	Yes
2014-10-01	Plan benefit arrangement – Insurance	Yes
2014-10-01	Plan benefit arrangement – General assets of the sponsor	Yes
2013: FIVE COUNTY CHILD DEVELOPMENT PROGRAM, INC HEALTH AND WELFARE PLAN 2013 form 5500 responses
2013-10-01	Type of plan entity	Single employer plan
2013-10-01	First time form 5500 has been submitted	Yes
2013-10-01	Plan funding arrangement – Insurance	Yes
2013-10-01	Plan funding arrangement – General assets of the sponsor	Yes
2013-10-01	Plan benefit arrangement – Insurance	Yes
2013-10-01	Plan benefit arrangement – General assets of the sponsor	Yes

Insurance Providers Used on plan

MONY (National Association of Insurance Commissioners NAIC id number: 78077 )

Policy contract number

000732

Policy instance

Insurance contract or identification number	000732
Number of Individuals Covered	130
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of fees paid to insurance company	USD $1,169
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $18,265
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	Yes
Amount paid for insurance broker fees	1169
Insurance broker organization code?	4

STARMOUNT LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68985 )

Policy contract number

425766

Policy instance

Insurance contract or identification number	425766
Number of Individuals Covered	124
Insurance policy start date	2019-10-01
Insurance policy end date	2020-10-01
Total amount of commissions paid to insurance broker	USD $7,353
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $58,488
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $5,515

TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )

Policy contract number

1C991

Policy instance

Insurance contract or identification number	1C991
Number of Individuals Covered	131
Insurance policy start date	2019-10-01
Insurance policy end date	2020-09-30
Total amount of commissions paid to insurance broker	USD $4,052
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $20,793
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,641

BLUE CROSS BLUE SHIELD OF MS, INC. (National Association of Insurance Commissioners NAIC id number: 60111 )

Policy contract number

0047445 ET AL

Policy instance

Insurance contract or identification number	0047445 ET AL
Number of Individuals Covered	127
Insurance policy start date	2019-10-01
Insurance policy end date	2020-09-30
Total amount of commissions paid to insurance broker	USD $25,812
Health Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $25,812
Insurance broker organization code?	3

TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )

Policy contract number

1C991

Policy instance

Insurance contract or identification number	1C991
Insurance policy start date	2018-10-01
Insurance policy end date	2019-09-30
Temporary Disability Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	Yes

MONY (National Association of Insurance Commissioners NAIC id number: 78077 )

Policy contract number

000732

Policy instance

Insurance contract or identification number	000732
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $1,169
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $18,265
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	Yes
Commission paid to Insurance Broker	USD $1,169
Insurance broker organization code?	3

BLUE CROSS BLUE SHIELD OF MS, INC. (National Association of Insurance Commissioners NAIC id number: 60111 )

Policy contract number

0047445 ET AL

Policy instance

Insurance contract or identification number	0047445 ET AL
Number of Individuals Covered	132
Insurance policy start date	2018-10-01
Insurance policy end date	2019-09-30
Total amount of commissions paid to insurance broker	USD $26,010
Health Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $26,010
Insurance broker organization code?	3

STARMOUNT LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68985 )

Policy contract number

425766

Policy instance

Insurance contract or identification number	425766
Number of Individuals Covered	127
Insurance policy start date	2018-10-01
Insurance policy end date	2019-10-01
Total amount of commissions paid to insurance broker	USD $6,992
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $57,237
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $5,244
Insurance broker organization code?	3

MONY (National Association of Insurance Commissioners NAIC id number: 78077 )

Policy contract number

732

Policy instance

Insurance contract or identification number	732
Insurance policy start date	2017-10-01
Insurance policy end date	2018-09-30
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	Yes

TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )

Policy contract number

1C991

Policy instance

Insurance contract or identification number	1C991
Number of Individuals Covered	158
Insurance policy start date	2017-10-01
Insurance policy end date	2018-09-30
Total amount of commissions paid to insurance broker	USD $2,946
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $9,455
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

BLUE CROSS BLUE SHIELD OF MS, INC. (National Association of Insurance Commissioners NAIC id number: 60111 )

Policy contract number

0047445 ET AL

Policy instance

Insurance contract or identification number	0047445 ET AL
Number of Individuals Covered	135
Insurance policy start date	2017-10-01
Insurance policy end date	2018-09-30
Total amount of commissions paid to insurance broker	USD $26,496
Health Insurance Welfare Benefit	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:	FIVE COUNTY CHILD DEVELOPMENT INC
Employer identification number (EIN):	640513252
NAIC Classification:	624100
NAIC Description:	Individual and Family Services