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COMMUNITY HEALTH CENTERS, INC. LIFE AND ACCIDENT 401k Plan overview

Plan NameCOMMUNITY HEALTH CENTERS, INC. LIFE AND ACCIDENT
Plan identification number 509

COMMUNITY HEALTH CENTERS, INC. LIFE AND ACCIDENT Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Life insurance
  • Temporary disability (accident and sickness)
  • 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.
  • Unfunded, fully insured, or combination unfunded/insured welfare plan that stopped filing form 5500s in an earlier plan year pursuant to 29 CFR 2520.104-20.

401k Sponsoring company profile

PEAK VISTA COMMUNITY HEALTH CENTERS has sponsored the creation of one or more 401k plans.

Company Name:PEAK VISTA COMMUNITY HEALTH CENTERS
Employer identification number (EIN):840617567
NAIC Classification:621498
NAIC Description:All Other Outpatient Care Centers

Additional information about PEAK VISTA COMMUNITY HEALTH CENTERS

Jurisdiction of Incorporation: Colorado Department of State
Incorporation Date: 1988-05-06
Company Identification Number: 19881043278
Legal Registered Office Address: 3205 N ACADEMY BLVD
SUITE 130
COLORADO SPRINGS
United States of America (USA)
80917

More information about PEAK VISTA COMMUNITY HEALTH CENTERS

Form 5500 Filing Information

Submission information for form 5500 for 401k plan COMMUNITY HEALTH CENTERS, INC. LIFE AND ACCIDENT

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5092015-01-01BRADY FITZWATER
5092015-01-01
5092014-01-01BRADY FITZWATER
5092013-01-01BRADY FITZWATER
5092012-01-01BRADY FITZWATER
5092011-01-01KATIE LUTZE
5092009-01-01GINA WISEMAN

Plan Statistics for COMMUNITY HEALTH CENTERS, INC. LIFE AND ACCIDENT

401k plan membership statisitcs for COMMUNITY HEALTH CENTERS, INC. LIFE AND ACCIDENT

Measure Date Value
2015: COMMUNITY HEALTH CENTERS, INC. LIFE AND ACCIDENT 2015 401k membership
Total participants, beginning-of-year2015-01-01124
Total number of active participants reported on line 7a of the Form 55002015-01-01120
Number of retired or separated participants receiving benefits2015-01-010
Number of other retired or separated participants entitled to future benefits2015-01-010
Total of all active and inactive participants2015-01-01120
2014: COMMUNITY HEALTH CENTERS, INC. LIFE AND ACCIDENT 2014 401k membership
Total participants, beginning-of-year2014-01-01143
Total number of active participants reported on line 7a of the Form 55002014-01-01124
Number of retired or separated participants receiving benefits2014-01-010
Number of other retired or separated participants entitled to future benefits2014-01-010
Total of all active and inactive participants2014-01-01124
2013: COMMUNITY HEALTH CENTERS, INC. LIFE AND ACCIDENT 2013 401k membership
Total participants, beginning-of-year2013-01-01138
Total number of active participants reported on line 7a of the Form 55002013-01-01143
Total of all active and inactive participants2013-01-01143
Total participants2013-01-01143
2012: COMMUNITY HEALTH CENTERS, INC. LIFE AND ACCIDENT 2012 401k membership
Total participants, beginning-of-year2012-01-01112
Total number of active participants reported on line 7a of the Form 55002012-01-01138
Total of all active and inactive participants2012-01-01138
Total participants2012-01-01138
2011: COMMUNITY HEALTH CENTERS, INC. LIFE AND ACCIDENT 2011 401k membership
Total participants, beginning-of-year2011-01-0199
Total number of active participants reported on line 7a of the Form 55002011-01-01112
Total of all active and inactive participants2011-01-01112
Total participants2011-01-01112
2009: COMMUNITY HEALTH CENTERS, INC. LIFE AND ACCIDENT 2009 401k membership
Total participants, beginning-of-year2009-01-01113
Total number of active participants reported on line 7a of the Form 55002009-01-0197
Total of all active and inactive participants2009-01-0197
Total participants2009-01-0197

Form 5500 Responses for COMMUNITY HEALTH CENTERS, INC. LIFE AND ACCIDENT

2015: COMMUNITY HEALTH CENTERS, INC. LIFE AND ACCIDENT 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Submission has been amendedNo
2015-01-01This submission is the final filingNo
2015-01-01This return/report is a short plan year return/report (less than 12 months)No
2015-01-01Plan is a collectively bargained planNo
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan benefit arrangement – InsuranceYes
2014: COMMUNITY HEALTH CENTERS, INC. LIFE AND ACCIDENT 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Submission has been amendedNo
2014-01-01This submission is the final filingNo
2014-01-01This return/report is a short plan year return/report (less than 12 months)No
2014-01-01Plan is a collectively bargained planNo
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan benefit arrangement – InsuranceYes
2013: COMMUNITY HEALTH CENTERS, INC. LIFE AND ACCIDENT 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan benefit arrangement – InsuranceYes
2012: COMMUNITY HEALTH CENTERS, INC. LIFE AND ACCIDENT 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan benefit arrangement – InsuranceYes
2011: COMMUNITY HEALTH CENTERS, INC. LIFE AND ACCIDENT 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Submission has been amendedYes
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan benefit arrangement – InsuranceYes
2009: COMMUNITY HEALTH CENTERS, INC. LIFE AND ACCIDENT 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 )
Policy contract numberE7599095
Policy instance 1
Insurance contract or identification numberE7599095
Number of Individuals Covered120
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $12,665
Total amount of fees paid to insurance companyUSD $2,270
Are there contracts with allocated funds for individual policies?No
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedVOLUNTARY BENEFITS
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $97,129
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 )
Policy contract numberE7599095
Policy instance 1
Insurance contract or identification numberE7599095
Number of Individuals Covered124
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $13,177
Total amount of fees paid to insurance companyUSD $365
Are there contracts with allocated funds for individual policies?No
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedVOLUNTARY BENEFITS
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $101,415
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $10,519
Amount paid for insurance broker fees73
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
Insurance broker nameVOLUNTARY SOLUTIONS, INC.
COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 )
Policy contract numberE7599095
Policy instance 1
Insurance contract or identification numberE7599095
Number of Individuals Covered143
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $11,793
Total amount of fees paid to insurance companyUSD $489
Other welfare benefits providedSUPPLEMENTAL LIFE & DISABILITY
Welfare Benefit Premiums Paid to CarrierUSD $103,735
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $10,408
Amount paid for insurance broker fees463
Insurance broker organization code?3
Insurance broker nameVOLUNTARY SOLUTIONS INC
COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 )
Policy contract numberE7599095
Policy instance 1
Insurance contract or identification numberE7599095
Number of Individuals Covered138
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $13,156
Total amount of fees paid to insurance companyUSD $624
Other welfare benefits providedSUPPLEMENTAL LIFE & DISABILITY
Welfare Benefit Premiums Paid to CarrierUSD $98,788
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $10,507
Amount paid for insurance broker fees417
Insurance broker organization code?3
Insurance broker nameVOLUNTARY SOLUTIONS INC
COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 )
Policy contract numberE7599095
Policy instance 1
Insurance contract or identification numberE7599095
Number of Individuals Covered112
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $10,733
Total amount of fees paid to insurance companyUSD $1,890
Other welfare benefits providedSUPPLEMENTAL LIFE & DISABILITY
Welfare Benefit Premiums Paid to CarrierUSD $87,703
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 )
Policy contract numberE7599095
Policy instance 1
Insurance contract or identification numberE7599095
Number of Individuals Covered99
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $8,524
Total amount of fees paid to insurance companyUSD $1,444
Other welfare benefits providedSUPPLEMENTAL LIFE & DISABILITY
Welfare Benefit Premiums Paid to CarrierUSD $72,554
Commission paid to Insurance BrokerUSD $7,306
Amount paid for insurance broker fees1235
Insurance broker organization code?3
Insurance broker nameDELIA B. CARTER

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