401k Plan data: KAISER PERMANENTE SELF-FUNDED HEALTH BENEFIT PLAN FOR MID-ATLANTIC PERMANENTE GROUP P.C. plan

KAISER PERMANENTE SELF-FUNDED HEALTH BENEFIT PLAN FOR MID-ATLANTIC PERMANENTE GROUP P.C. 401k Plan overview

Plan Name	KAISER PERMANENTE SELF-FUNDED HEALTH BENEFIT PLAN FOR MID-ATLANTIC PERMANENTE GROUP P.C.
Plan identification number	560

KAISER PERMANENTE SELF-FUNDED HEALTH BENEFIT PLAN FOR MID-ATLANTIC PERMANENTE GROUP P.C. Benefits

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

401k Sponsoring company profile

MID-ATLANTIC PERMANENTE MEDICAL GROUP has sponsored the creation of one or more 401k plans.

Company Name: MID-ATLANTIC PERMANENTE MEDICAL GROUP

Employer identification number (EIN): 521196226

NAIC Classification: 621112
NAIC Description: Offices of Physicians, Mental Health Specialists

Form 5500 Filing Information

Submission information for form 5500 for 401k plan KAISER PERMANENTE SELF-FUNDED HEALTH BENEFIT PLAN FOR MID-ATLANTIC PERMANENTE GROUP P.C.

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
560 2015-01-01
560 2014-01-01 DONNA J SMITH
560 2013-01-01 HARRIET E GUBERMAN
560 2012-01-01 HARRIET GUBERMAN
560 2011-01-01 HARRIET GUBERMAN
560 2009-01-01 HARRIET GUBERMAN

Plan Statistics for KAISER PERMANENTE SELF-FUNDED HEALTH BENEFIT PLAN FOR MID-ATLANTIC PERMANENTE GROUP P.C.

401k plan membership statisitcs for KAISER PERMANENTE SELF-FUNDED HEALTH BENEFIT PLAN FOR MID-ATLANTIC PERMANENTE GROUP P.C.

Measure Date Value
2015: KAISER PERMANENTE SELF-FUNDED HEALTH BENEFIT PLAN FOR MID-ATLANTIC PERMANENTE GROUP P.C. 2015 401k membership
Total participants, beginning-of-year 2015-01-01 1,374
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 0
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 0
2014: KAISER PERMANENTE SELF-FUNDED HEALTH BENEFIT PLAN FOR MID-ATLANTIC PERMANENTE GROUP P.C. 2014 401k membership
Total participants, beginning-of-year 2014-01-01 968
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 1,162
Number of retired or separated participants receiving benefits 2014-01-01 212
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 1,374
2013: KAISER PERMANENTE SELF-FUNDED HEALTH BENEFIT PLAN FOR MID-ATLANTIC PERMANENTE GROUP P.C. 2013 401k membership
Total participants, beginning-of-year 2013-01-01 918
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 968
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 2013-01-01 968
2012: KAISER PERMANENTE SELF-FUNDED HEALTH BENEFIT PLAN FOR MID-ATLANTIC PERMANENTE GROUP P.C. 2012 401k membership
Total participants, beginning-of-year 2012-01-01 854
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 918
Number of retired or separated participants receiving benefits 2012-01-01 0
Total of all active and inactive participants 2012-01-01 918
2011: KAISER PERMANENTE SELF-FUNDED HEALTH BENEFIT PLAN FOR MID-ATLANTIC PERMANENTE GROUP P.C. 2011 401k membership
Total participants, beginning-of-year 2011-01-01 778
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 854
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 2011-01-01 854
Total participants 2011-01-01 854
2009: KAISER PERMANENTE SELF-FUNDED HEALTH BENEFIT PLAN FOR MID-ATLANTIC PERMANENTE GROUP P.C. 2009 401k membership
Total participants, beginning-of-year 2009-01-01 620
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 711
Number of retired or separated participants receiving benefits 2009-01-01 0
Number of other retired or separated participants entitled to future benefits 2009-01-01 0
Total of all active and inactive participants 2009-01-01 711

Measure	Date	Value
2015: KAISER PERMANENTE SELF-FUNDED HEALTH BENEFIT PLAN FOR MID-ATLANTIC PERMANENTE GROUP P.C. 2015 401k membership
Total participants, beginning-of-year	2015-01-01	1,374
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	0
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	0
2014: KAISER PERMANENTE SELF-FUNDED HEALTH BENEFIT PLAN FOR MID-ATLANTIC PERMANENTE GROUP P.C. 2014 401k membership
Total participants, beginning-of-year	2014-01-01	968
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	1,162
Number of retired or separated participants receiving benefits	2014-01-01	212
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	1,374
2013: KAISER PERMANENTE SELF-FUNDED HEALTH BENEFIT PLAN FOR MID-ATLANTIC PERMANENTE GROUP P.C. 2013 401k membership
Total participants, beginning-of-year	2013-01-01	918
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	968
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	968
2012: KAISER PERMANENTE SELF-FUNDED HEALTH BENEFIT PLAN FOR MID-ATLANTIC PERMANENTE GROUP P.C. 2012 401k membership
Total participants, beginning-of-year	2012-01-01	854
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	918
Number of retired or separated participants receiving benefits	2012-01-01	0
Total of all active and inactive participants	2012-01-01	918
2011: KAISER PERMANENTE SELF-FUNDED HEALTH BENEFIT PLAN FOR MID-ATLANTIC PERMANENTE GROUP P.C. 2011 401k membership
Total participants, beginning-of-year	2011-01-01	778
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	854
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	854
Total participants	2011-01-01	854
2009: KAISER PERMANENTE SELF-FUNDED HEALTH BENEFIT PLAN FOR MID-ATLANTIC PERMANENTE GROUP P.C. 2009 401k membership
Total participants, beginning-of-year	2009-01-01	620
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	711
Number of retired or separated participants receiving benefits	2009-01-01	0
Number of other retired or separated participants entitled to future benefits	2009-01-01	0
Total of all active and inactive participants	2009-01-01	711

Form 5500 Responses for KAISER PERMANENTE SELF-FUNDED HEALTH BENEFIT PLAN FOR MID-ATLANTIC PERMANENTE GROUP P.C.

2015: KAISER PERMANENTE SELF-FUNDED HEALTH BENEFIT PLAN FOR MID-ATLANTIC PERMANENTE GROUP P.C. 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	Yes
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: KAISER PERMANENTE SELF-FUNDED HEALTH BENEFIT PLAN FOR MID-ATLANTIC PERMANENTE GROUP P.C. 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: KAISER PERMANENTE SELF-FUNDED HEALTH BENEFIT PLAN FOR MID-ATLANTIC PERMANENTE GROUP P.C. 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: KAISER PERMANENTE SELF-FUNDED HEALTH BENEFIT PLAN FOR MID-ATLANTIC PERMANENTE GROUP P.C. 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: KAISER PERMANENTE SELF-FUNDED HEALTH BENEFIT PLAN FOR MID-ATLANTIC PERMANENTE GROUP P.C. 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
2009: KAISER PERMANENTE SELF-FUNDED HEALTH BENEFIT PLAN FOR MID-ATLANTIC PERMANENTE GROUP P.C. 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	Submission has been amended	No
2009-01-01	This submission is the final filing	No
2009-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-01-01	Plan is a collectively bargained plan	No
2009-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2009-01-01	Plan benefit arrangement – General assets of the sponsor	Yes

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Company Name:	MID-ATLANTIC PERMANENTE MEDICAL GROUP
Employer identification number (EIN):	521196226
NAIC Classification:	621112
NAIC Description:	Offices of Physicians, Mental Health Specialists

Plan id#	Filing Submission Date	Name of Administrator
560	2015-01-01
560	2014-01-01	DONNA J SMITH
560	2013-01-01	HARRIET E GUBERMAN
560	2012-01-01	HARRIET GUBERMAN
560	2011-01-01	HARRIET GUBERMAN
560	2009-01-01	HARRIET GUBERMAN