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| Plan Name | FLINT RIVER HOSPITAL 401(K) SAVINGS PLAN |
| Plan identification number | 001 |
| 401k Plan Type | Defined Contribution Pension |
| Plan Features/Benefits |
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| Company Name: | PREMIER HEALTHCARE INVESTORS, LLC |
| Employer identification number (EIN): | 462546172 |
| NAIC Classification: | 621111 |
| NAIC Description: | Offices of Physicians (except Mental Health Specialists) |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 001 | 2018-01-01 | JOHN HOPFENSPERGER | 2019-04-03 | ||
| 001 | 2017-01-01 | JOHN HOPFENSPERGER |
| Measure | Date | Value |
|---|---|---|
| 2017: FLINT RIVER HOSPITAL 401(K) SAVINGS PLAN 2017 401k membership | ||
| Total participants, beginning-of-year | 2017-01-01 | 48 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-01-01 | 35 |
| 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 | 35 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2017-01-01 | 0 |
| Total participants | 2017-01-01 | 35 |
| Number of participants with account balances | 2017-01-01 | 35 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2017-01-01 | 0 |
| Measure | Date | Value |
|---|---|---|
| 2017 : FLINT RIVER HOSPITAL 401(K) SAVINGS PLAN 2017 401k financial data | ||
| Total income from all sources | 2017-12-31 | $108,782 |
| Expenses. Total of all expenses incurred | 2017-12-31 | $165,305 |
| Benefits paid (including direct rollovers) | 2017-12-31 | $164,449 |
| Total plan assets at end of year | 2017-12-31 | $1,239,537 |
| Total plan assets at beginning of year | 2017-12-31 | $1,296,060 |
| Value of fidelity bond covering the plan | 2017-12-31 | $250,000 |
| Total contributions received or receivable from participants | 2017-12-31 | $14,961 |
| Contributions received from other sources (not participants or employers) | 2017-12-31 | $3,981 |
| Other income received | 2017-12-31 | $89,840 |
| Net income (gross income less expenses) | 2017-12-31 | $-56,523 |
| Net plan assets at end of year (total assets less liabilities) | 2017-12-31 | $1,239,537 |
| Net plan assets at beginning of year (total assets less liabilities) | 2017-12-31 | $1,296,060 |
| Assets. Value of participant loans | 2017-12-31 | $13,509 |
| Total contributions received or receivable from employer(s) | 2017-12-31 | $0 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2017-12-31 | $856 |
| Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities | 2017-12-31 | $0 |
| 2017: FLINT RIVER HOSPITAL 401(K) SAVINGS PLAN 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 – Trust | Yes |
| 2017-01-01 | Plan benefit arrangement - Trust | Yes |
| JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 ) | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | 118613 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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