401k Plan data: BLACK HILLS SURGICAL HOSPITAL, LLP plan

BLACK HILLS SURGICAL HOSPITAL, LLP 401k Plan overview

Plan Name	BLACK HILLS SURGICAL HOSPITAL, LLP
Plan identification number	503

BLACK HILLS SURGICAL HOSPITAL, LLP Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) 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.

401k Sponsoring company profile

BLACK HILLS SURGICAL HOSPITAL, LLP has sponsored the creation of one or more 401k plans.

Company Name: BLACK HILLS SURGICAL HOSPITAL, LLP

Employer identification number (EIN): 460440466

NAIC Classification: 622000
NAIC Description: Hospitals

Form 5500 Filing Information

Submission information for form 5500 for 401k plan BLACK HILLS SURGICAL HOSPITAL, LLP

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
503 2021-01-01
503 2020-01-01
503 2019-01-01
503 2018-01-01 JACK KAUP JACK KAUP 2019-05-16
503 2017-01-01 JACK KAUP JACK KAUP 2018-05-15
503 2016-01-01 JACK KAUP JACK KAUP 2017-05-16
503 2015-01-01 JACK KAUP JACK KAUP 2016-05-10
503 2014-01-01 JACK KAUP JACK KAUP 2015-05-27
503 2013-01-01 JACK KAUP JACK KAUP 2014-05-05
503 2012-01-01 JACK KAUP JACK KAUP 2013-07-05
503 2011-01-01 JACK KAUP JACK KAUP 2012-07-16
503 2010-01-01 JACK KAUP JACK KAUP 2011-06-16

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
503	2021-01-01
503	2020-01-01
503	2019-01-01
503	2018-01-01	JACK KAUP	JACK KAUP	2019-05-16
503	2017-01-01	JACK KAUP	JACK KAUP	2018-05-15
503	2016-01-01	JACK KAUP	JACK KAUP	2017-05-16
503	2015-01-01	JACK KAUP	JACK KAUP	2016-05-10
503	2014-01-01	JACK KAUP	JACK KAUP	2015-05-27
503	2013-01-01	JACK KAUP	JACK KAUP	2014-05-05
503	2012-01-01	JACK KAUP	JACK KAUP	2013-07-05
503	2011-01-01	JACK KAUP	JACK KAUP	2012-07-16
503	2010-01-01	JACK KAUP	JACK KAUP	2011-06-16

Plan Statistics for BLACK HILLS SURGICAL HOSPITAL, LLP

401k plan membership statisitcs for BLACK HILLS SURGICAL HOSPITAL, LLP

Measure Date Value
2021: BLACK HILLS SURGICAL HOSPITAL, LLP 2021 401k membership
Total participants, beginning-of-year 2021-01-01 71
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 57
Number of retired or separated participants receiving benefits 2021-01-01 0
Number of other retired or separated participants entitled to future benefits 2021-01-01 0
Total of all active and inactive participants 2021-01-01 57
2020: BLACK HILLS SURGICAL HOSPITAL, LLP 2020 401k membership
Total participants, beginning-of-year 2020-01-01 76
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 71
Number of retired or separated participants receiving benefits 2020-01-01 0
Number of other retired or separated participants entitled to future benefits 2020-01-01 0
Total of all active and inactive participants 2020-01-01 71
2019: BLACK HILLS SURGICAL HOSPITAL, LLP 2019 401k membership
Total participants, beginning-of-year 2019-01-01 72
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 76
Number of retired or separated participants receiving benefits 2019-01-01 0
Number of other retired or separated participants entitled to future benefits 2019-01-01 0
Total of all active and inactive participants 2019-01-01 76
2018: BLACK HILLS SURGICAL HOSPITAL, LLP 2018 401k membership
Total participants, beginning-of-year 2018-01-01 84
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 72
Number of retired or separated participants receiving benefits 2018-01-01 0
Number of other retired or separated participants entitled to future benefits 2018-01-01 0
Total of all active and inactive participants 2018-01-01 72
2017: BLACK HILLS SURGICAL HOSPITAL, LLP 2017 401k membership
Total participants, beginning-of-year 2017-01-01 77
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 84
Number of retired or separated participants receiving benefits 2017-01-01 0
Number of other retired or separated participants entitled to future benefits 2017-01-01 0
Total of all active and inactive participants 2017-01-01 84
2016: BLACK HILLS SURGICAL HOSPITAL, LLP 2016 401k membership
Total participants, beginning-of-year 2016-01-01 88
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 77
Number of retired or separated participants receiving benefits 2016-01-01 0
Number of other retired or separated participants entitled to future benefits 2016-01-01 0
Total of all active and inactive participants 2016-01-01 77
2015: BLACK HILLS SURGICAL HOSPITAL, LLP 2015 401k membership
Total participants, beginning-of-year 2015-01-01 110
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 88
Number of retired or separated participants receiving benefits 2015-01-01 0
Number of other retired or separated participants entitled to future benefits 2015-01-01 0
Total of all active and inactive participants 2015-01-01 88
2014: BLACK HILLS SURGICAL HOSPITAL, LLP 2014 401k membership
Total participants, beginning-of-year 2014-01-01 103
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 110
Number of retired or separated participants receiving benefits 2014-01-01 0
Number of other retired or separated participants entitled to future benefits 2014-01-01 0
Total of all active and inactive participants 2014-01-01 110
2013: BLACK HILLS SURGICAL HOSPITAL, LLP 2013 401k membership
Total participants, beginning-of-year 2013-01-01 118
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 103
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 2013-01-01 103
2012: BLACK HILLS SURGICAL HOSPITAL, LLP 2012 401k membership
Total participants, beginning-of-year 2012-01-01 97
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 118
Number of retired or separated participants receiving benefits 2012-01-01 0
Number of other retired or separated participants entitled to future benefits 2012-01-01 0
Total of all active and inactive participants 2012-01-01 118
2011: BLACK HILLS SURGICAL HOSPITAL, LLP 2011 401k membership
Total participants, beginning-of-year 2011-01-01 106
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 97
Number of retired or separated participants receiving benefits 2011-01-01 0
Number of other retired or separated participants entitled to future benefits 2011-01-01 0
Total of all active and inactive participants 2011-01-01 97
2010: BLACK HILLS SURGICAL HOSPITAL, LLP 2010 401k membership
Total participants, beginning-of-year 2010-01-01 115
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 106
Number of retired or separated participants receiving benefits 2010-01-01 0
Number of other retired or separated participants entitled to future benefits 2010-01-01 0
Total of all active and inactive participants 2010-01-01 106

Measure	Date	Value
2021: BLACK HILLS SURGICAL HOSPITAL, LLP 2021 401k membership
Total participants, beginning-of-year	2021-01-01	71
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	57
Number of retired or separated participants receiving benefits	2021-01-01	0
Number of other retired or separated participants entitled to future benefits	2021-01-01	0
Total of all active and inactive participants	2021-01-01	57
2020: BLACK HILLS SURGICAL HOSPITAL, LLP 2020 401k membership
Total participants, beginning-of-year	2020-01-01	76
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	71
Number of retired or separated participants receiving benefits	2020-01-01	0
Number of other retired or separated participants entitled to future benefits	2020-01-01	0
Total of all active and inactive participants	2020-01-01	71
2019: BLACK HILLS SURGICAL HOSPITAL, LLP 2019 401k membership
Total participants, beginning-of-year	2019-01-01	72
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	76
Number of retired or separated participants receiving benefits	2019-01-01	0
Number of other retired or separated participants entitled to future benefits	2019-01-01	0
Total of all active and inactive participants	2019-01-01	76
2018: BLACK HILLS SURGICAL HOSPITAL, LLP 2018 401k membership
Total participants, beginning-of-year	2018-01-01	84
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	72
Number of retired or separated participants receiving benefits	2018-01-01	0
Number of other retired or separated participants entitled to future benefits	2018-01-01	0
Total of all active and inactive participants	2018-01-01	72
2017: BLACK HILLS SURGICAL HOSPITAL, LLP 2017 401k membership
Total participants, beginning-of-year	2017-01-01	77
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	84
Number of retired or separated participants receiving benefits	2017-01-01	0
Number of other retired or separated participants entitled to future benefits	2017-01-01	0
Total of all active and inactive participants	2017-01-01	84
2016: BLACK HILLS SURGICAL HOSPITAL, LLP 2016 401k membership
Total participants, beginning-of-year	2016-01-01	88
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	77
Number of retired or separated participants receiving benefits	2016-01-01	0
Number of other retired or separated participants entitled to future benefits	2016-01-01	0
Total of all active and inactive participants	2016-01-01	77
2015: BLACK HILLS SURGICAL HOSPITAL, LLP 2015 401k membership
Total participants, beginning-of-year	2015-01-01	110
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	88
Number of retired or separated participants receiving benefits	2015-01-01	0
Number of other retired or separated participants entitled to future benefits	2015-01-01	0
Total of all active and inactive participants	2015-01-01	88
2014: BLACK HILLS SURGICAL HOSPITAL, LLP 2014 401k membership
Total participants, beginning-of-year	2014-01-01	103
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	110
Number of retired or separated participants receiving benefits	2014-01-01	0
Number of other retired or separated participants entitled to future benefits	2014-01-01	0
Total of all active and inactive participants	2014-01-01	110
2013: BLACK HILLS SURGICAL HOSPITAL, LLP 2013 401k membership
Total participants, beginning-of-year	2013-01-01	118
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	103
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	103
2012: BLACK HILLS SURGICAL HOSPITAL, LLP 2012 401k membership
Total participants, beginning-of-year	2012-01-01	97
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	118
Number of retired or separated participants receiving benefits	2012-01-01	0
Number of other retired or separated participants entitled to future benefits	2012-01-01	0
Total of all active and inactive participants	2012-01-01	118
2011: BLACK HILLS SURGICAL HOSPITAL, LLP 2011 401k membership
Total participants, beginning-of-year	2011-01-01	106
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	97
Number of retired or separated participants receiving benefits	2011-01-01	0
Number of other retired or separated participants entitled to future benefits	2011-01-01	0
Total of all active and inactive participants	2011-01-01	97
2010: BLACK HILLS SURGICAL HOSPITAL, LLP 2010 401k membership
Total participants, beginning-of-year	2010-01-01	115
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	106
Number of retired or separated participants receiving benefits	2010-01-01	0
Number of other retired or separated participants entitled to future benefits	2010-01-01	0
Total of all active and inactive participants	2010-01-01	106

Form 5500 Responses for BLACK HILLS SURGICAL HOSPITAL, LLP

2021: BLACK HILLS SURGICAL HOSPITAL, LLP 2021 form 5500 responses
2021-01-01	Type of plan entity	Single employer plan
2021-01-01	Submission has been amended	No
2021-01-01	This submission is the final filing	No
2021-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2021-01-01	Plan is a collectively bargained plan	No
2021-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2021-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2020: BLACK HILLS SURGICAL HOSPITAL, LLP 2020 form 5500 responses
2020-01-01	Type of plan entity	Single employer plan
2020-01-01	Submission has been amended	No
2020-01-01	This submission is the final filing	No
2020-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2020-01-01	Plan is a collectively bargained plan	No
2020-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2020-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2019: BLACK HILLS SURGICAL HOSPITAL, LLP 2019 form 5500 responses
2019-01-01	Type of plan entity	Single employer plan
2019-01-01	Submission has been amended	No
2019-01-01	This submission is the final filing	No
2019-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2019-01-01	Plan is a collectively bargained plan	No
2019-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2019-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2018: BLACK HILLS SURGICAL HOSPITAL, LLP 2018 form 5500 responses
2018-01-01	Type of plan entity	Single employer plan
2018-01-01	Submission has been amended	No
2018-01-01	This submission is the final filing	No
2018-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2018-01-01	Plan is a collectively bargained plan	No
2018-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2018-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2017: BLACK HILLS SURGICAL HOSPITAL, LLP 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	Submission has been amended	No
2017-01-01	This submission is the final filing	No
2017-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2017-01-01	Plan is a collectively bargained plan	No
2017-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2017-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2016: BLACK HILLS SURGICAL HOSPITAL, LLP 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Submission has been amended	No
2016-01-01	This submission is the final filing	No
2016-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-01-01	Plan is a collectively bargained plan	No
2016-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2016-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2015: BLACK HILLS SURGICAL HOSPITAL, LLP 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Submission has been amended	No
2015-01-01	This submission is the final filing	No
2015-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-01-01	Plan is a collectively bargained plan	No
2015-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2015-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2014: BLACK HILLS SURGICAL HOSPITAL, LLP 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Submission has been amended	No
2014-01-01	This submission is the final filing	No
2014-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-01-01	Plan is a collectively bargained plan	No
2014-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2014-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2013: BLACK HILLS SURGICAL HOSPITAL, LLP 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: BLACK HILLS SURGICAL HOSPITAL, LLP 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Submission has been amended	No
2012-01-01	This submission is the final filing	No
2012-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-01-01	Plan is a collectively bargained plan	No
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: BLACK HILLS SURGICAL HOSPITAL, LLP 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Submission has been amended	No
2011-01-01	This submission is the final filing	No
2011-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-01-01	Plan is a collectively bargained plan	No
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: BLACK HILLS SURGICAL HOSPITAL, LLP 2010 form 5500 responses
2010-01-01	Type of plan entity	Single employer plan
2010-01-01	First time form 5500 has been submitted	Yes
2010-01-01	Submission has been amended	No
2010-01-01	This submission is the final filing	No
2010-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2010-01-01	Plan is a collectively bargained plan	No
2010-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2010-01-01	Plan benefit arrangement – General assets of the sponsor	Yes

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Company Name:	BLACK HILLS SURGICAL HOSPITAL, LLP
Employer identification number (EIN):	460440466
NAIC Classification:	622000
NAIC Description:	Hospitals