401k Plan data: PHOENIX HEALTH SYSTEM, INC. GROUP BENEFITS PLAN plan

PHOENIX HEALTH SYSTEM, INC. GROUP BENEFITS PLAN 401k Plan overview

Plan Name	PHOENIX HEALTH SYSTEM, INC. GROUP BENEFITS PLAN
Plan identification number	501

PHOENIX HEALTH SYSTEM, INC. GROUP BENEFITS PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) Life insurance Dental Vision Temporary disability (accident and sickness) Long-term disability cover

401k Sponsoring company profile

PHOENIX HEALTH SYSTEMS, INC. has sponsored the creation of one or more 401k plans.

Company Name: PHOENIX HEALTH SYSTEMS, INC.

Employer identification number (EIN): 521289872

NAIC Classification: 541600

Additional information about PHOENIX HEALTH SYSTEMS, INC.

Jurisdiction of Incorporation: Wyoming Corporations Division

Incorporation Date: 2014-09-25

Company Identification Number: 000672714

Legal Registered Office Address: 824 E Janss Rd

Thousand Oaks
United States of America (USA)
91360

More information about PHOENIX HEALTH SYSTEMS, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan PHOENIX HEALTH SYSTEM, INC. GROUP BENEFITS PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2014-01-01 LISA EBERSOLE LISA EBERSOLE 2015-08-10
501 2013-01-01 RONALD GUE
501 2012-01-01 KELLEY VEST
501 2011-01-01 CYNTHIA TALLEY
501 2009-01-01 DON P. MURPHY JOHN M. SABIN 2010-10-11

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
501	2014-01-01	LISA EBERSOLE	LISA EBERSOLE	2015-08-10
501	2013-01-01	RONALD GUE
501	2012-01-01	KELLEY VEST
501	2011-01-01	CYNTHIA TALLEY
501	2009-01-01	DON P. MURPHY	JOHN M. SABIN	2010-10-11

Plan Statistics for PHOENIX HEALTH SYSTEM, INC. GROUP BENEFITS PLAN

401k plan membership statisitcs for PHOENIX HEALTH SYSTEM, INC. GROUP BENEFITS PLAN

Measure Date Value
2014: PHOENIX HEALTH SYSTEM, INC. GROUP BENEFITS PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 50
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 26
Total of all active and inactive participants 2014-01-01 26
2013: PHOENIX HEALTH SYSTEM, INC. GROUP BENEFITS PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 73
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 50
Total of all active and inactive participants 2013-01-01 50
2012: PHOENIX HEALTH SYSTEM, INC. GROUP BENEFITS PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 108
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 73
Total of all active and inactive participants 2012-01-01 73
2011: PHOENIX HEALTH SYSTEM, INC. GROUP BENEFITS PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 110
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 108
Total of all active and inactive participants 2011-01-01 108
2009: PHOENIX HEALTH SYSTEM, INC. GROUP BENEFITS PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 296
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 293
Number of retired or separated participants receiving benefits 2009-01-01 3
Number of other retired or separated participants entitled to future benefits 2009-01-01 0
Total of all active and inactive participants 2009-01-01 296

Measure	Date	Value
2014: PHOENIX HEALTH SYSTEM, INC. GROUP BENEFITS PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	50
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	26
Total of all active and inactive participants	2014-01-01	26
2013: PHOENIX HEALTH SYSTEM, INC. GROUP BENEFITS PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	73
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	50
Total of all active and inactive participants	2013-01-01	50
2012: PHOENIX HEALTH SYSTEM, INC. GROUP BENEFITS PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	108
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	73
Total of all active and inactive participants	2012-01-01	73
2011: PHOENIX HEALTH SYSTEM, INC. GROUP BENEFITS PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	110
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	108
Total of all active and inactive participants	2011-01-01	108
2009: PHOENIX HEALTH SYSTEM, INC. GROUP BENEFITS PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	296
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	293
Number of retired or separated participants receiving benefits	2009-01-01	3
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	296

Form 5500 Responses for PHOENIX HEALTH SYSTEM, INC. GROUP BENEFITS PLAN

2014: PHOENIX HEALTH SYSTEM, INC. GROUP BENEFITS PLAN 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 – Insurance	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes
2013: PHOENIX HEALTH SYSTEM, INC. GROUP BENEFITS PLAN 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 – Insurance	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2012: PHOENIX HEALTH SYSTEM, INC. GROUP BENEFITS PLAN 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 – Insurance	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2011: PHOENIX HEALTH SYSTEM, INC. GROUP BENEFITS PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Submission has been amended	Yes
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 – Insurance	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2009: PHOENIX HEALTH SYSTEM, INC. GROUP BENEFITS PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	First time form 5500 has been submitted	Yes
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 – Insurance	Yes
2009-01-01	Plan benefit arrangement – Insurance	Yes

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Company Name:	PHOENIX HEALTH SYSTEMS, INC.
Employer identification number (EIN):	521289872
NAIC Classification:	541600

Jurisdiction of Incorporation:	Wyoming Corporations Division
Incorporation Date:	2014-09-25
Company Identification Number:	000672714
Legal Registered Office Address:	824 E Janss Rd Thousand Oaks United States of America (USA) 91360