401k Plan data: GREATER SEACOAST COMMUNITY HEALTH HEALTH PLAN plan

GREATER SEACOAST COMMUNITY HEALTH HEALTH PLAN 401k Plan overview

Plan Name	GREATER SEACOAST COMMUNITY HEALTH HEALTH PLAN
Plan identification number	502

GREATER SEACOAST COMMUNITY HEALTH HEALTH PLAN Benefits

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

401k Sponsoring company profile

GREATER SEACOAST COMMUNITY HEALTH has sponsored the creation of one or more 401k plans.

Company Name: GREATER SEACOAST COMMUNITY HEALTH

Employer identification number (EIN): 020304203

NAIC Classification: 621498
NAIC Description: All Other Outpatient Care Centers

Form 5500 Filing Information

Submission information for form 5500 for 401k plan GREATER SEACOAST COMMUNITY HEALTH HEALTH PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
502 2018-01-01

Plan Statistics for GREATER SEACOAST COMMUNITY HEALTH HEALTH PLAN

401k plan membership statisitcs for GREATER SEACOAST COMMUNITY HEALTH HEALTH PLAN

Measure Date Value
2018: GREATER SEACOAST COMMUNITY HEALTH HEALTH PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 126
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 0
Number of retired or separated participants receiving benefits 2018-01-01 0
Number of other retired or separated participants entitled to future benefits 2018-01-01 0
Total of all active and inactive participants 2018-01-01 0
Number of employers contributing to the scheme 2018-01-01 0

Measure	Date	Value
2018: GREATER SEACOAST COMMUNITY HEALTH HEALTH PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	126
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	0
Number of retired or separated participants receiving benefits	2018-01-01	0
Number of other retired or separated participants entitled to future benefits	2018-01-01	0
Total of all active and inactive participants	2018-01-01	0
Number of employers contributing to the scheme	2018-01-01	0

Form 5500 Responses for GREATER SEACOAST COMMUNITY HEALTH HEALTH PLAN

2018: GREATER SEACOAST COMMUNITY HEALTH HEALTH PLAN 2018 form 5500 responses
2018-01-01	Type of plan entity	Single employer plan
2018-01-01	First time form 5500 has been submitted	Yes
2018-01-01	This submission is the final filing	Yes
2018-01-01	Plan funding arrangement – Insurance	Yes
2018-01-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

HPHC INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 18975 )

Policy contract number

73276

Policy instance

Insurance contract or identification number	73276
Number of Individuals Covered	0
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $553
Total amount of fees paid to insurance company	USD $0
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $14,716
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $553
Amount paid for insurance broker fees	0
Insurance broker organization code?	3

HARVARD PILGRIM HEALTH CARE OF NE, INC. (National Association of Insurance Commissioners NAIC id number: 96917 )

Policy contract number

44381

Policy instance

Insurance contract or identification number	44381
Number of Individuals Covered	150
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $41,673
Total amount of fees paid to insurance company	USD $0
Health Insurance Welfare Benefit	Yes
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	No
Unemployment Insurance Welfare Benefit	No
Welfare Benefit Premiums Paid to Carrier	USD $1,199,449
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	Yes
Commission paid to Insurance Broker	USD $41,673
Amount paid for insurance broker fees	0
Insurance broker organization code?	3

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Company Name:	GREATER SEACOAST COMMUNITY HEALTH
Employer identification number (EIN):	020304203
NAIC Classification:	621498
NAIC Description:	All Other Outpatient Care Centers