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GREATER OREGON BEHAVIORAL HEALTH, INC. ADMINISTRATION LIFE AND AD&D PLAN 401k Plan overview

Plan NameGREATER OREGON BEHAVIORAL HEALTH, INC. ADMINISTRATION LIFE AND AD&D PLAN
Plan identification number 502

GREATER OREGON BEHAVIORAL HEALTH, INC. ADMINISTRATION LIFE AND AD&D PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Life insurance
  • Death benefits (include travel accident but not life insurance)

401k Sponsoring company profile

GREATER OREGON BEHAVIORAL HEALTH has sponsored the creation of one or more 401k plans.

Company Name:GREATER OREGON BEHAVIORAL HEALTH
Employer identification number (EIN):931144014
NAIC Classification:561110
NAIC Description:Office Administrative Services

Additional information about GREATER OREGON BEHAVIORAL HEALTH

Jurisdiction of Incorporation: Oregon Secretary of State Corporations Division
Incorporation Date: 1994-05-02
Company Identification Number: 39865688
Legal Registered Office Address: 401 E 3RD ST STE 101

THE DALLES
United States of America (USA)
97058

More information about GREATER OREGON BEHAVIORAL HEALTH

Form 5500 Filing Information

Submission information for form 5500 for 401k plan GREATER OREGON BEHAVIORAL HEALTH, INC. ADMINISTRATION LIFE AND AD&D PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5022020-01-01LISA CHAMNESS2021-05-11
5022019-01-01KAREN WHEELER2020-07-16
5022018-01-01KEVIN M. CAMPBELL2019-07-26
5022017-01-01

Plan Statistics for GREATER OREGON BEHAVIORAL HEALTH, INC. ADMINISTRATION LIFE AND AD&D PLAN

401k plan membership statisitcs for GREATER OREGON BEHAVIORAL HEALTH, INC. ADMINISTRATION LIFE AND AD&D PLAN

Measure Date Value
2020: GREATER OREGON BEHAVIORAL HEALTH, INC. ADMINISTRATION LIFE AND AD&D PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-0195
Total number of active participants reported on line 7a of the Form 55002020-01-010
Number of retired or separated participants receiving benefits2020-01-010
Number of other retired or separated participants entitled to future benefits2020-01-010
Total of all active and inactive participants2020-01-010
Number of employers contributing to the scheme2020-01-010
2019: GREATER OREGON BEHAVIORAL HEALTH, INC. ADMINISTRATION LIFE AND AD&D PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-01160
Total number of active participants reported on line 7a of the Form 55002019-01-01145
Number of retired or separated participants receiving benefits2019-01-010
Number of other retired or separated participants entitled to future benefits2019-01-010
Total of all active and inactive participants2019-01-01145
Number of employers contributing to the scheme2019-01-010
2018: GREATER OREGON BEHAVIORAL HEALTH, INC. ADMINISTRATION LIFE AND AD&D PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-01127
Total number of active participants reported on line 7a of the Form 55002018-01-01159
Number of retired or separated participants receiving benefits2018-01-010
Number of other retired or separated participants entitled to future benefits2018-01-010
Total of all active and inactive participants2018-01-01159
Number of employers contributing to the scheme2018-01-010
2017: GREATER OREGON BEHAVIORAL HEALTH, INC. ADMINISTRATION LIFE AND AD&D PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-01108
Total number of active participants reported on line 7a of the Form 55002017-01-01125
Number of retired or separated participants receiving benefits2017-01-010
Number of other retired or separated participants entitled to future benefits2017-01-010
Total of all active and inactive participants2017-01-01125

Form 5500 Responses for GREATER OREGON BEHAVIORAL HEALTH, INC. ADMINISTRATION LIFE AND AD&D PLAN

2020: GREATER OREGON BEHAVIORAL HEALTH, INC. ADMINISTRATION LIFE AND AD&D PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01This submission is the final filingYes
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan benefit arrangement – InsuranceYes
2019: GREATER OREGON BEHAVIORAL HEALTH, INC. ADMINISTRATION LIFE AND AD&D PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan benefit arrangement – InsuranceYes
2018: GREATER OREGON BEHAVIORAL HEALTH, INC. ADMINISTRATION LIFE AND AD&D PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan benefit arrangement – InsuranceYes
2017: GREATER OREGON BEHAVIORAL HEALTH, INC. ADMINISTRATION LIFE AND AD&D PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01First time form 5500 has been submittedYes
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number154728
Policy instance 1
Insurance contract or identification number154728
Number of Individuals Covered96
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $2,445
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,056
Amount paid for insurance broker fees0
Insurance broker organization code?3
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number154728
Policy instance 1
Insurance contract or identification number154728
Number of Individuals Covered146
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $3,182
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,182
Amount paid for insurance broker fees0
Insurance broker organization code?3
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number154728
Policy instance 1
Insurance contract or identification number154728
Number of Individuals Covered159
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $3,357
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,357
Amount paid for insurance broker fees0
Insurance broker organization code?3
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number154728
Policy instance 1
Insurance contract or identification number154728
Number of Individuals Covered125
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $1,538
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,538
Amount paid for insurance broker fees0
Insurance broker organization code?3
Insurance broker nameJD FULWILER AND CO INSURANCE

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