401k Plan data: HEALTH FIRST, INC. LIFE INSURANCE PLAN plan

HEALTH FIRST, INC. LIFE INSURANCE PLAN 401k Plan overview

Plan Name	HEALTH FIRST, INC. LIFE INSURANCE PLAN
Plan identification number	501

HEALTH FIRST, INC. LIFE INSURANCE PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Life insurance Temporary disability (accident and sickness) Long-term disability cover

401k Sponsoring company profile

HEALTH FIRST SHARED SERVICES, INC. has sponsored the creation of one or more 401k plans.

Company Name: HEALTH FIRST SHARED SERVICES, INC.

Employer identification number (EIN): 553336894

NAIC Classification: 622000
NAIC Description: Hospitals

Form 5500 Filing Information

Submission information for form 5500 for 401k plan HEALTH FIRST, INC. LIFE INSURANCE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2020-01-01

Plan Statistics for HEALTH FIRST, INC. LIFE INSURANCE PLAN

401k plan membership statisitcs for HEALTH FIRST, INC. LIFE INSURANCE PLAN

Measure Date Value
2020: HEALTH FIRST, INC. LIFE INSURANCE PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 7,151
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 7,342
Total of all active and inactive participants 2020-01-01 7,342
Total participants 2020-01-01 7,342

Measure	Date	Value
2020: HEALTH FIRST, INC. LIFE INSURANCE PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	7,151
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	7,342
Total of all active and inactive participants	2020-01-01	7,342
Total participants	2020-01-01	7,342

Form 5500 Responses for HEALTH FIRST, INC. LIFE INSURANCE PLAN

2020: HEALTH FIRST, INC. LIFE INSURANCE PLAN 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 – Insurance	Yes
2020-01-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65675 )

Policy contract number

000010233076

Policy instance

Insurance contract or identification number	000010233076
Number of Individuals Covered	7342
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $84,900
Total amount of fees paid to insurance company	USD $227,390
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Welfare Benefit Premiums Paid to Carrier	USD $1,753,796
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $42,928
Amount paid for insurance broker fees	181600
Additional information about fees paid to insurance broker	CONSULTING, SPECIALTY BONUS, ACQUISITION FEES, SUPPLEMENTAL COMP
Insurance broker organization code?	3

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65675 )

Policy contract number

000010233077

Policy instance

Insurance contract or identification number	000010233077
Number of Individuals Covered	6725
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $95,456
Total amount of fees paid to insurance company	USD $259,393
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	Yes
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Welfare Benefit Premiums Paid to Carrier	USD $1,990,423
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $48,990
Amount paid for insurance broker fees	207137
Additional information about fees paid to insurance broker	CONSULTING, SPECIALTY BONUS, ACQUISITION FEES, SUPPLEMENTAL COMP
Insurance broker organization code?	3

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65675 )

Policy contract number

000010233078

Policy instance

Insurance contract or identification number	000010233078
Number of Individuals Covered	4049
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $102,197
Total amount of fees paid to insurance company	USD $273,516
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Welfare Benefit Premiums Paid to Carrier	USD $2,122,921
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $52,135
Amount paid for insurance broker fees	217906
Additional information about fees paid to insurance broker	CONSULTING, SPECIALTY BONUS, ACQUISITION FEES, SUPPLEMENTAL COMP
Insurance broker organization code?	3

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Company Name:	HEALTH FIRST SHARED SERVICES, INC.
Employer identification number (EIN):	553336894
NAIC Classification:	622000
NAIC Description:	Hospitals