401k Plan data: LINCOLN NATIONAL LIFE INSURANCE VOLUNTARY LIFE plan

LINCOLN NATIONAL LIFE INSURANCE VOLUNTARY LIFE 401k Plan overview

Plan Name	LINCOLN NATIONAL LIFE INSURANCE VOLUNTARY LIFE
Plan identification number	507

LINCOLN NATIONAL LIFE INSURANCE VOLUNTARY LIFE Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Life insurance

401k Sponsoring company profile

KINGS DAUGHTERS MEDICAL CENTER has sponsored the creation of one or more 401k plans.

Company Name: KINGS DAUGHTERS MEDICAL CENTER

Employer identification number (EIN): 640333594

NAIC Classification: 622000
NAIC Description: Hospitals

Form 5500 Filing Information

Submission information for form 5500 for 401k plan LINCOLN NATIONAL LIFE INSURANCE VOLUNTARY LIFE

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
507 2013-01-01 CELINE CRAIG ALVIN HOOVER 2014-07-11
507 2013-01-01
507 2012-01-01 CELINE CRAIG ALVIN HOOVER 2013-07-03
507 2011-01-01 CELINE CRAIG ALVIN HOOVER 2012-06-29
507 2010-02-01 CELINE CRAIG ALVIN HOOVER 2012-06-29
507 2009-02-01 CELINE CRAIG ALVIN HOOVER 2010-07-01

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
507	2013-01-01	CELINE CRAIG	ALVIN HOOVER	2014-07-11
507	2013-01-01
507	2012-01-01	CELINE CRAIG	ALVIN HOOVER	2013-07-03
507	2011-01-01	CELINE CRAIG	ALVIN HOOVER	2012-06-29
507	2010-02-01	CELINE CRAIG	ALVIN HOOVER	2012-06-29
507	2009-02-01	CELINE CRAIG	ALVIN HOOVER	2010-07-01

Plan Statistics for LINCOLN NATIONAL LIFE INSURANCE VOLUNTARY LIFE

401k plan membership statisitcs for LINCOLN NATIONAL LIFE INSURANCE VOLUNTARY LIFE

Measure Date Value
2013: LINCOLN NATIONAL LIFE INSURANCE VOLUNTARY LIFE 2013 401k membership
Total participants, beginning-of-year 2013-01-01 245
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 230
Total of all active and inactive participants 2013-01-01 230
Total participants 2013-01-01 230
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
2012: LINCOLN NATIONAL LIFE INSURANCE VOLUNTARY LIFE 2012 401k membership
Total participants, beginning-of-year 2012-01-01 208
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 245
Total of all active and inactive participants 2012-01-01 245
Total participants 2012-01-01 245
2011: LINCOLN NATIONAL LIFE INSURANCE VOLUNTARY LIFE 2011 401k membership
Total participants, beginning-of-year 2011-01-01 206
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 208
Total of all active and inactive participants 2011-01-01 208
Total participants 2011-01-01 208
2010: LINCOLN NATIONAL LIFE INSURANCE VOLUNTARY LIFE 2010 401k membership
Total participants, beginning-of-year 2010-02-01 188
Total number of active participants reported on line 7a of the Form 5500 2010-02-01 206
Total of all active and inactive participants 2010-02-01 206
Total participants 2010-02-01 206
2009: LINCOLN NATIONAL LIFE INSURANCE VOLUNTARY LIFE 2009 401k membership
Total participants, beginning-of-year 2009-02-01 190
Total number of active participants reported on line 7a of the Form 5500 2009-02-01 188
Total of all active and inactive participants 2009-02-01 188
Total participants 2009-02-01 188

Measure	Date	Value
2013: LINCOLN NATIONAL LIFE INSURANCE VOLUNTARY LIFE 2013 401k membership
Total participants, beginning-of-year	2013-01-01	245
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	230
Total of all active and inactive participants	2013-01-01	230
Total participants	2013-01-01	230
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
2012: LINCOLN NATIONAL LIFE INSURANCE VOLUNTARY LIFE 2012 401k membership
Total participants, beginning-of-year	2012-01-01	208
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	245
Total of all active and inactive participants	2012-01-01	245
Total participants	2012-01-01	245
2011: LINCOLN NATIONAL LIFE INSURANCE VOLUNTARY LIFE 2011 401k membership
Total participants, beginning-of-year	2011-01-01	206
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	208
Total of all active and inactive participants	2011-01-01	208
Total participants	2011-01-01	208
2010: LINCOLN NATIONAL LIFE INSURANCE VOLUNTARY LIFE 2010 401k membership
Total participants, beginning-of-year	2010-02-01	188
Total number of active participants reported on line 7a of the Form 5500	2010-02-01	206
Total of all active and inactive participants	2010-02-01	206
Total participants	2010-02-01	206
2009: LINCOLN NATIONAL LIFE INSURANCE VOLUNTARY LIFE 2009 401k membership
Total participants, beginning-of-year	2009-02-01	190
Total number of active participants reported on line 7a of the Form 5500	2009-02-01	188
Total of all active and inactive participants	2009-02-01	188
Total participants	2009-02-01	188

Form 5500 Responses for LINCOLN NATIONAL LIFE INSURANCE VOLUNTARY LIFE

2013: LINCOLN NATIONAL LIFE INSURANCE VOLUNTARY LIFE 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: LINCOLN NATIONAL LIFE INSURANCE VOLUNTARY LIFE 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: LINCOLN NATIONAL LIFE INSURANCE VOLUNTARY LIFE 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 – Insurance	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2010: LINCOLN NATIONAL LIFE INSURANCE VOLUNTARY LIFE 2010 form 5500 responses
2010-02-01	Type of plan entity	Single employer plan
2010-02-01	Submission has been amended	No
2010-02-01	This submission is the final filing	No
2010-02-01	This return/report is a short plan year return/report (less than 12 months)	No
2010-02-01	Plan is a collectively bargained plan	No
2010-02-01	Plan funding arrangement – Insurance	Yes
2010-02-01	Plan benefit arrangement – Insurance	Yes
2009: LINCOLN NATIONAL LIFE INSURANCE VOLUNTARY LIFE 2009 form 5500 responses
2009-02-01	Type of plan entity	Single employer plan
2009-02-01	Submission has been amended	No
2009-02-01	This submission is the final filing	No
2009-02-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-02-01	Plan is a collectively bargained plan	No
2009-02-01	Plan funding arrangement – Insurance	Yes
2009-02-01	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

400077831

Policy instance

Insurance contract or identification number	400077831
Number of Individuals Covered	230
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $6,719
Total amount of fees paid to insurance company	USD $0
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
Other welfare benefits provided	VOLUNTARY CHILD LIFE, VOLUNTARY SPOUSE AD&D, VOLUNTARY SPOUSE LIFE, VOLUNTARY AD&D, VOLUNTARY LIFE
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 $67,188
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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Company Name:	KINGS DAUGHTERS MEDICAL CENTER
Employer identification number (EIN):	640333594
NAIC Classification:	622000
NAIC Description:	Hospitals