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ONE COMMUNITY HEALTH WELFARE BENEFIT PLAN 401k Plan overview

Plan NameONE COMMUNITY HEALTH WELFARE BENEFIT PLAN
Plan identification number 502

ONE COMMUNITY HEALTH WELFARE BENEFIT PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Vision
  • Temporary disability (accident and sickness)
  • Long-term disability cover
  • Death benefits (include travel accident but not life insurance)
  • Other welfare benefit cover

401k Sponsoring company profile

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

Company Name:ONE COMMUNITY HEALTH
Employer identification number (EIN):930910794
NAIC Classification:621410
NAIC Description:Family Planning Centers

Additional information about ONE COMMUNITY HEALTH

Jurisdiction of Incorporation: Oregon Secretary of State Corporations Division
Incorporation Date: 1986-03-12
Company Identification Number: 2450989
Legal Registered Office Address: 849 PACIFIC AVE

HOOD RIVER
United States of America (USA)
97031

More information about ONE COMMUNITY HEALTH

Form 5500 Filing Information

Submission information for form 5500 for 401k plan ONE COMMUNITY HEALTH WELFARE BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5022023-01-01JENNIFER GRIFFITH2024-07-10
5022022-01-01JENNIFER GRIFFITH2023-07-20
5022021-01-01JENNIFER GRIFFITH2022-09-27
5022020-02-01JENNIFER GRIFFITH2021-07-29
5022019-02-01JENNIFER GRIFFITH2020-12-18
5022018-02-01JENNIFER GRIFFITH2020-12-18
5022017-02-01JENNIFER GRIFFITH2020-12-18
5022016-02-01JENNIFER GRIFFITH2020-12-18

Form 5500 Responses for ONE COMMUNITY HEALTH WELFARE BENEFIT PLAN

2023: ONE COMMUNITY HEALTH WELFARE BENEFIT PLAN 2023 form 5500 responses
2023-01-01Type of plan entitySingle employer plan
2023-01-01Plan funding arrangement – InsuranceYes
2023-01-01Plan funding arrangement – General assets of the sponsorYes
2023-01-01Plan benefit arrangement – InsuranceYes
2023-01-01Plan benefit arrangement – General assets of the sponsorYes
2022: ONE COMMUNITY HEALTH WELFARE BENEFIT PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan funding arrangement – General assets of the sponsorYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement – General assets of the sponsorYes
2021: ONE COMMUNITY HEALTH WELFARE BENEFIT PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan funding arrangement – General assets of the sponsorYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement – General assets of the sponsorYes
2020: ONE COMMUNITY HEALTH WELFARE BENEFIT PLAN 2020 form 5500 responses
2020-02-01Type of plan entitySingle employer plan
2020-02-01This return/report is a short plan year return/report (less than 12 months)Yes
2020-02-01Plan funding arrangement – InsuranceYes
2020-02-01Plan funding arrangement – General assets of the sponsorYes
2020-02-01Plan benefit arrangement – InsuranceYes
2020-02-01Plan benefit arrangement – General assets of the sponsorYes
2019: ONE COMMUNITY HEALTH WELFARE BENEFIT PLAN 2019 form 5500 responses
2019-02-01Type of plan entitySingle employer plan
2019-02-01Plan funding arrangement – InsuranceYes
2019-02-01Plan funding arrangement – General assets of the sponsorYes
2019-02-01Plan benefit arrangement – InsuranceYes
2019-02-01Plan benefit arrangement – General assets of the sponsorYes
2018: ONE COMMUNITY HEALTH WELFARE BENEFIT PLAN 2018 form 5500 responses
2018-02-01Type of plan entitySingle employer plan
2018-02-01Plan funding arrangement – InsuranceYes
2018-02-01Plan benefit arrangement – InsuranceYes
2017: ONE COMMUNITY HEALTH WELFARE BENEFIT PLAN 2017 form 5500 responses
2017-02-01Type of plan entitySingle employer plan
2017-02-01Plan funding arrangement – InsuranceYes
2017-02-01Plan benefit arrangement – InsuranceYes
2016: ONE COMMUNITY HEALTH WELFARE BENEFIT PLAN 2016 form 5500 responses
2016-02-01Type of plan entitySingle employer plan
2016-02-01First time form 5500 has been submittedYes
2016-02-01Plan funding arrangement – InsuranceYes
2016-02-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number39209
Policy instance 3
Insurance contract or identification number39209
Number of Individuals Covered409
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $1,994
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $21,728
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 number5968687
Policy instance 2
Insurance contract or identification number5968687
Number of Individuals Covered345
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $16,557
Total amount of fees paid to insurance companyUSD $7,503
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT, EMPLOYEE ASSISTANCE PROGRAM
Welfare Benefit Premiums Paid to CarrierUSD $195,848
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number628992
Policy instance 1
Insurance contract or identification number628992
Number of Individuals Covered337
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $8,284
Total amount of fees paid to insurance companyUSD $85,713
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,110,156
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 number226994
Policy instance 5
Insurance contract or identification number226994
Number of Individuals Covered86
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $3,888
Total amount of fees paid to insurance companyUSD $251
Other welfare benefits providedCRITICAL ILLNESS
Welfare Benefit Premiums Paid to CarrierUSD $11,371
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 number226995
Policy instance 4
Insurance contract or identification number226995
Number of Individuals Covered140
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $4,735
Total amount of fees paid to insurance companyUSD $378
Other welfare benefits providedACCIDENT
Welfare Benefit Premiums Paid to CarrierUSD $13,645
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 number5968687
Policy instance 3
Insurance contract or identification number5968687
Number of Individuals Covered339
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $19,013
Total amount of fees paid to insurance companyUSD $9,757
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT, EMPLOYEE ASSISTANCE PROGRAM,ACCIDENT,CRITICAL ILLNESS
Welfare Benefit Premiums Paid to CarrierUSD $353,280
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
NATIONAL GUARDIAN LIFE (National Association of Insurance Commissioners NAIC id number: 66583 )
Policy contract number39209
Policy instance 2
Insurance contract or identification number39209
Number of Individuals Covered233
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $2,664
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $21,345
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number628992
Policy instance 1
Insurance contract or identification number628992
Number of Individuals Covered317
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $85,831
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,827,047
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
NATIONAL GUARDIAN LIFE (National Association of Insurance Commissioners NAIC id number: 66583 )
Policy contract number39209
Policy instance 3
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number5968687
Policy instance 2
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number628992
Policy instance 1
UNITED HEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number39209
Policy instance 3
UNITED HEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number5968687
Policy instance 2
UNITED HEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number628992
Policy instance 1
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number395113
Policy instance 2
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number908877
Policy instance 1
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number395113
Policy instance 1
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number395113
Policy instance 1
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number395113
Policy instance 1

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