401k Plan data: ALEXIAN BROTHERS SENIOR MINISTRIES HEALTH REIMBURSEMENT ARRANGEMENT plan

ALEXIAN BROTHERS SENIOR MINISTRIES HEALTH REIMBURSEMENT ARRANGEMENT 401k Plan overview

Plan Name	ALEXIAN BROTHERS SENIOR MINISTRIES HEALTH REIMBURSEMENT ARRANGEMENT
Plan identification number	515

ALEXIAN BROTHERS SENIOR MINISTRIES HEALTH REIMBURSEMENT ARRANGEMENT Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Other welfare benefit cover

401k Sponsoring company profile

ALEXIAN BROTHERS SENIOR MINISTRIES has sponsored the creation of one or more 401k plans.

Company Name: ALEXIAN BROTHERS SENIOR MINISTRIES

Employer identification number (EIN): 364484290

NAIC Classification: 623000
NAIC Description: Nursing and Residential Care Facilities

Form 5500 Filing Information

Submission information for form 5500 for 401k plan ALEXIAN BROTHERS SENIOR MINISTRIES HEALTH REIMBURSEMENT ARRANGEMENT

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
515 2013-01-01 DAVID WOLFE
515 2012-01-01 BRIAN WIEKRYKAS
515 2011-01-01 KEITH CONBOY
515 2010-11-01 KEITH CONBOY

Plan id#	Filing Submission Date	Name of Administrator
515	2013-01-01	DAVID WOLFE
515	2012-01-01	BRIAN WIEKRYKAS
515	2011-01-01	KEITH CONBOY
515	2010-11-01	KEITH CONBOY

Plan Statistics for ALEXIAN BROTHERS SENIOR MINISTRIES HEALTH REIMBURSEMENT ARRANGEMENT

401k plan membership statisitcs for ALEXIAN BROTHERS SENIOR MINISTRIES HEALTH REIMBURSEMENT ARRANGEMENT

Measure Date Value
2013: ALEXIAN BROTHERS SENIOR MINISTRIES HEALTH REIMBURSEMENT ARRANGEMENT 2013 401k membership
Total participants, beginning-of-year 2013-01-01 582
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 557
Number of retired or separated participants receiving benefits 2013-01-01 0
Number of other retired or separated participants entitled to future benefits 2013-01-01 0
Total of all active and inactive participants 2013-01-01 557
2012: ALEXIAN BROTHERS SENIOR MINISTRIES HEALTH REIMBURSEMENT ARRANGEMENT 2012 401k membership
Total participants, beginning-of-year 2012-01-01 379
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 360
Total of all active and inactive participants 2012-01-01 360
Total participants 2012-01-01 0
2011: ALEXIAN BROTHERS SENIOR MINISTRIES HEALTH REIMBURSEMENT ARRANGEMENT 2011 401k membership
Total participants, beginning-of-year 2011-01-01 798
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 756
Total of all active and inactive participants 2011-01-01 756
Total participants 2011-01-01 756
2010: ALEXIAN BROTHERS SENIOR MINISTRIES HEALTH REIMBURSEMENT ARRANGEMENT 2010 401k membership
Total participants, beginning-of-year 2010-11-01 739
Total number of active participants reported on line 7a of the Form 5500 2010-11-01 739
Total of all active and inactive participants 2010-11-01 739
Total participants 2010-11-01 739

Measure	Date	Value
2013: ALEXIAN BROTHERS SENIOR MINISTRIES HEALTH REIMBURSEMENT ARRANGEMENT 2013 401k membership
Total participants, beginning-of-year	2013-01-01	582
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	557
Number of retired or separated participants receiving benefits	2013-01-01	0
Number of other retired or separated participants entitled to future benefits	2013-01-01	0
Total of all active and inactive participants	2013-01-01	557
2012: ALEXIAN BROTHERS SENIOR MINISTRIES HEALTH REIMBURSEMENT ARRANGEMENT 2012 401k membership
Total participants, beginning-of-year	2012-01-01	379
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	360
Total of all active and inactive participants	2012-01-01	360
Total participants	2012-01-01	0
2011: ALEXIAN BROTHERS SENIOR MINISTRIES HEALTH REIMBURSEMENT ARRANGEMENT 2011 401k membership
Total participants, beginning-of-year	2011-01-01	798
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	756
Total of all active and inactive participants	2011-01-01	756
Total participants	2011-01-01	756
2010: ALEXIAN BROTHERS SENIOR MINISTRIES HEALTH REIMBURSEMENT ARRANGEMENT 2010 401k membership
Total participants, beginning-of-year	2010-11-01	739
Total number of active participants reported on line 7a of the Form 5500	2010-11-01	739
Total of all active and inactive participants	2010-11-01	739
Total participants	2010-11-01	739

Form 5500 Responses for ALEXIAN BROTHERS SENIOR MINISTRIES HEALTH REIMBURSEMENT ARRANGEMENT

2013: ALEXIAN BROTHERS SENIOR MINISTRIES HEALTH REIMBURSEMENT ARRANGEMENT 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Submission has been amended	No
2013-01-01	This submission is the final filing	No
2013-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-01-01	Plan is a collectively bargained plan	No
2013-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2013-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2012: ALEXIAN BROTHERS SENIOR MINISTRIES HEALTH REIMBURSEMENT ARRANGEMENT 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2012-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2011: ALEXIAN BROTHERS SENIOR MINISTRIES HEALTH REIMBURSEMENT ARRANGEMENT 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2011-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2010: ALEXIAN BROTHERS SENIOR MINISTRIES HEALTH REIMBURSEMENT ARRANGEMENT 2010 form 5500 responses
2010-11-01	Type of plan entity	Single employer plan
2010-11-01	First time form 5500 has been submitted	Yes
2010-11-01	This return/report is a short plan year return/report (less than 12 months)	Yes
2010-11-01	Plan funding arrangement – General assets of the sponsor	Yes
2010-11-01	Plan benefit arrangement – General assets of the sponsor	Yes

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Company Name:	ALEXIAN BROTHERS SENIOR MINISTRIES
Employer identification number (EIN):	364484290
NAIC Classification:	623000
NAIC Description:	Nursing and Residential Care Facilities