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| Plan Name | CENTER FOR BEHAVIORAL HEALTH WELFARE BENEFIT PLAN |
| Plan identification number | 501 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | CENTER FOR BEHAVIORAL HEALTH |
| Employer identification number (EIN): | 861011031 |
| NAIC Classification: | 621420 |
| NAIC Description: | Outpatient Mental Health and Substance Abuse Centers |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 501 | 2021-04-01 | BRANT MASSMAN | 2022-06-16 | ||
| 501 | 2020-04-01 | TONYA ROMERO | 2021-08-18 | ||
| 501 | 2019-04-01 | TONYA ROMERO | 2020-10-21 | ||
| 501 | 2018-04-01 | TONYA ROMERO | 2019-10-28 | ||
| 501 | 2017-04-01 |
| 2021: CENTER FOR BEHAVIORAL HEALTH WELFARE BENEFIT PLAN 2021 form 5500 responses | ||
|---|---|---|
| 2021-04-01 | Type of plan entity | Single employer plan |
| 2021-04-01 | This submission is the final filing | Yes |
| 2021-04-01 | This return/report is a short plan year return/report (less than 12 months) | Yes |
| 2021-04-01 | Plan funding arrangement – Insurance | Yes |
| 2021-04-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2021-04-01 | Plan benefit arrangement – Insurance | Yes |
| 2021-04-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2020: CENTER FOR BEHAVIORAL HEALTH WELFARE BENEFIT PLAN 2020 form 5500 responses | ||
| 2020-04-01 | Type of plan entity | Single employer plan |
| 2020-04-01 | Plan funding arrangement – Insurance | Yes |
| 2020-04-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2020-04-01 | Plan benefit arrangement – Insurance | Yes |
| 2020-04-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2019: CENTER FOR BEHAVIORAL HEALTH WELFARE BENEFIT PLAN 2019 form 5500 responses | ||
| 2019-04-01 | Type of plan entity | Single employer plan |
| 2019-04-01 | Plan funding arrangement – Insurance | Yes |
| 2019-04-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2019-04-01 | Plan benefit arrangement – Insurance | Yes |
| 2019-04-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2018: CENTER FOR BEHAVIORAL HEALTH WELFARE BENEFIT PLAN 2018 form 5500 responses | ||
| 2018-04-01 | Type of plan entity | Single employer plan |
| 2018-04-01 | Plan funding arrangement – Insurance | Yes |
| 2018-04-01 | Plan benefit arrangement – Insurance | Yes |
| 2017: CENTER FOR BEHAVIORAL HEALTH WELFARE BENEFIT PLAN 2017 form 5500 responses | ||
| 2017-04-01 | Type of plan entity | Single employer plan |
| 2017-04-01 | First time form 5500 has been submitted | Yes |
| 2017-04-01 | Plan funding arrangement – Insurance | Yes |
| 2017-04-01 | Plan benefit arrangement – Insurance | Yes |
| BLUE CROSS OF IDAHO HEALTH SERVICE INC. (National Association of Insurance Commissioners NAIC id number: 60095 ) | |
| Policy contract number | 10038092 |
| Policy instance | 3 |
| AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 ) | |
| Policy contract number | 010-043266 |
| Policy instance | 2 |
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) | |
| Policy contract number | 5935998 |
| Policy instance | 1 |
| AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 ) | |
| Policy contract number | 010-043266 |
| Policy instance | 2 |
| BLUE CROSS OF IDAHO HEALTH SERVICE INC. (National Association of Insurance Commissioners NAIC id number: 60095 ) | |
| Policy contract number | 10038092 |
| Policy instance | 3 |
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) | |
| Policy contract number | 5935998 |
| Policy instance | 1 |
| BANNER HEALTH AND AETNA HEALTH (National Association of Insurance Commissioners NAIC id number: 16058 ) | |
| Policy contract number | 781157BH |
| Policy instance | 4 |
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) | |
| Policy contract number | 5935998 |
| Policy instance | 2 |
| AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) | |
| Policy contract number | 0781157 |
| Policy instance | 1 |
| AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 ) | |
| Policy contract number | 010-043266 |
| Policy instance | 3 |
| BANNER HEALTH AND AETNA HEALTH (National Association of Insurance Commissioners NAIC id number: 16058 ) | |
| Policy contract number | 0781157BH |
| Policy instance | 4 |
| AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 ) | |
| Policy contract number | 010-043266 |
| Policy instance | 3 |
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) | |
| Policy contract number | KMO5935998 |
| Policy instance | 2 |
| AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) | |
| Policy contract number | 0781157 |
| Policy instance | 1 |
| AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 ) | |
| Policy contract number | 010-043266 |
| Policy instance | 3 |
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) | |
| Policy contract number | KMO5935998 |
| Policy instance | 2 |
| AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) | |
| Policy contract number | 0781157 |
| Policy instance | 1 |
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