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

BAYSTATE HEALTH SYSTEM, INC. HEALTH BENEFITS PLAN 401k Plan overview

Plan Name	BAYSTATE HEALTH SYSTEM, INC. HEALTH BENEFITS PLAN
Plan identification number	510

BAYSTATE HEALTH SYSTEM, INC. HEALTH BENEFITS PLAN Benefits

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

401k Sponsoring company profile

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

Company Name: BAYSTATE HEALTH, INC.

Employer identification number (EIN): 042105941

NAIC Classification: 622000
NAIC Description: Hospitals

Form 5500 Filing Information

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

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
510 2022-01-01
510 2021-01-01
510 2020-01-01
510 2019-01-01
510 2018-01-01
510 2017-01-01 DONNA BREWER
510 2017-01-01 DONNA BREWER
510 2016-01-01 DONNA BREWER DONNA BREWER 2017-10-16
510 2015-01-01 DONNA BREWER CEBS CMS RPA DIRECTOR
510 2015-01-01 DONNA LYNN BREWER DONNA LYNN BREWER 2018-01-09
510 2014-01-01 CHRISTINE LESSARD, CCP SPHR
510 2014-01-01 DONNA BREWER DONNA BREWER 2018-01-10
510 2013-01-01 MARY DUNN MARY DUNN 2014-10-14
510 2012-01-01 MARY DUNN MARY DUNN 2013-10-10
510 2011-01-01 MARY DUNN
510 2010-01-01 MARY DUNN
510 2009-01-01 MARY DUNN MARY DUNN 2010-10-14

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
510	2022-01-01
510	2021-01-01
510	2020-01-01
510	2019-01-01
510	2018-01-01
510	2017-01-01	DONNA BREWER
510	2017-01-01	DONNA BREWER
510	2016-01-01	DONNA BREWER	DONNA BREWER	2017-10-16
510	2015-01-01	DONNA BREWER CEBS CMS RPA DIRECTOR
510	2015-01-01	DONNA LYNN BREWER	DONNA LYNN BREWER	2018-01-09
510	2014-01-01	CHRISTINE LESSARD, CCP SPHR
510	2014-01-01	DONNA BREWER	DONNA BREWER	2018-01-10
510	2013-01-01	MARY DUNN	MARY DUNN	2014-10-14
510	2012-01-01	MARY DUNN	MARY DUNN	2013-10-10
510	2011-01-01	MARY DUNN
510	2010-01-01	MARY DUNN
510	2009-01-01	MARY DUNN	MARY DUNN	2010-10-14

Plan Statistics for BAYSTATE HEALTH SYSTEM, INC. HEALTH BENEFITS PLAN

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

Measure Date Value
2022: BAYSTATE HEALTH SYSTEM, INC. HEALTH BENEFITS PLAN 2022 401k membership
Total participants, beginning-of-year 2022-01-01 9,184
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 9,074
Number of retired or separated participants receiving benefits 2022-01-01 95
Number of other retired or separated participants entitled to future benefits 2022-01-01 0
Total of all active and inactive participants 2022-01-01 9,169
2021: BAYSTATE HEALTH SYSTEM, INC. HEALTH BENEFITS PLAN 2021 401k membership
Total participants, beginning-of-year 2021-01-01 9,159
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 9,110
Number of retired or separated participants receiving benefits 2021-01-01 96
Number of other retired or separated participants entitled to future benefits 2021-01-01 0
Total of all active and inactive participants 2021-01-01 9,206
2020: BAYSTATE HEALTH SYSTEM, INC. HEALTH BENEFITS PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 8,594
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 8,262
Number of retired or separated participants receiving benefits 2020-01-01 87
Number of other retired or separated participants entitled to future benefits 2020-01-01 0
Total of all active and inactive participants 2020-01-01 8,349
2019: BAYSTATE HEALTH SYSTEM, INC. HEALTH BENEFITS PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 8,353
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 8,240
Number of retired or separated participants receiving benefits 2019-01-01 120
Number of other retired or separated participants entitled to future benefits 2019-01-01 0
Total of all active and inactive participants 2019-01-01 8,360
2018: BAYSTATE HEALTH SYSTEM, INC. HEALTH BENEFITS PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 7,678
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 7,895
Number of retired or separated participants receiving benefits 2018-01-01 162
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 8,057
2017: BAYSTATE HEALTH SYSTEM, INC. HEALTH BENEFITS PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 7,453
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 7,371
Number of retired or separated participants receiving benefits 2017-01-01 157
Number of other retired or separated participants entitled to future benefits 2017-01-01 0
Total of all active and inactive participants 2017-01-01 7,528
2016: BAYSTATE HEALTH SYSTEM, INC. HEALTH BENEFITS PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 6,237
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 7,359
Number of retired or separated participants receiving benefits 2016-01-01 122
Number of other retired or separated participants entitled to future benefits 2016-01-01 0
Total of all active and inactive participants 2016-01-01 7,481
2015: BAYSTATE HEALTH SYSTEM, INC. HEALTH BENEFITS PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 7,047
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 7,529
Total of all active and inactive participants 2015-01-01 7,529
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
2014: BAYSTATE HEALTH SYSTEM, INC. HEALTH BENEFITS PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 6,905
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 7,047
Total of all active and inactive participants 2014-01-01 7,047
Number of retired or separated participants receiving benefits 2014-01-01 0
Number of other retired or separated participants entitled to future benefits 2014-01-01 0
2013: BAYSTATE HEALTH SYSTEM, INC. HEALTH BENEFITS PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 6,900
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 6,905
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 6,905
2012: BAYSTATE HEALTH SYSTEM, INC. HEALTH BENEFITS PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 6,895
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 6,900
Number of retired or separated participants receiving benefits 2012-01-01 0
Number of other retired or separated participants entitled to future benefits 2012-01-01 0
Total of all active and inactive participants 2012-01-01 6,900
2011: BAYSTATE HEALTH SYSTEM, INC. HEALTH BENEFITS PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 7,020
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 6,895
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 6,895
2010: BAYSTATE HEALTH SYSTEM, INC. HEALTH BENEFITS PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 6,905
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 7,020
Number of retired or separated participants receiving benefits 2010-01-01 0
Number of other retired or separated participants entitled to future benefits 2010-01-01 0
Total of all active and inactive participants 2010-01-01 7,020
2009: BAYSTATE HEALTH SYSTEM, INC. HEALTH BENEFITS PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 6,859
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 6,905
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 6,905

Measure	Date	Value
2022: BAYSTATE HEALTH SYSTEM, INC. HEALTH BENEFITS PLAN 2022 401k membership
Total participants, beginning-of-year	2022-01-01	9,184
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	9,074
Number of retired or separated participants receiving benefits	2022-01-01	95
Number of other retired or separated participants entitled to future benefits	2022-01-01	0
Total of all active and inactive participants	2022-01-01	9,169
2021: BAYSTATE HEALTH SYSTEM, INC. HEALTH BENEFITS PLAN 2021 401k membership
Total participants, beginning-of-year	2021-01-01	9,159
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	9,110
Number of retired or separated participants receiving benefits	2021-01-01	96
Number of other retired or separated participants entitled to future benefits	2021-01-01	0
Total of all active and inactive participants	2021-01-01	9,206
2020: BAYSTATE HEALTH SYSTEM, INC. HEALTH BENEFITS PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	8,594
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	8,262
Number of retired or separated participants receiving benefits	2020-01-01	87
Number of other retired or separated participants entitled to future benefits	2020-01-01	0
Total of all active and inactive participants	2020-01-01	8,349
2019: BAYSTATE HEALTH SYSTEM, INC. HEALTH BENEFITS PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	8,353
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	8,240
Number of retired or separated participants receiving benefits	2019-01-01	120
Number of other retired or separated participants entitled to future benefits	2019-01-01	0
Total of all active and inactive participants	2019-01-01	8,360
2018: BAYSTATE HEALTH SYSTEM, INC. HEALTH BENEFITS PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	7,678
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	7,895
Number of retired or separated participants receiving benefits	2018-01-01	162
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	8,057
2017: BAYSTATE HEALTH SYSTEM, INC. HEALTH BENEFITS PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	7,453
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	7,371
Number of retired or separated participants receiving benefits	2017-01-01	157
Number of other retired or separated participants entitled to future benefits	2017-01-01	0
Total of all active and inactive participants	2017-01-01	7,528
2016: BAYSTATE HEALTH SYSTEM, INC. HEALTH BENEFITS PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	6,237
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	7,359
Number of retired or separated participants receiving benefits	2016-01-01	122
Number of other retired or separated participants entitled to future benefits	2016-01-01	0
Total of all active and inactive participants	2016-01-01	7,481
2015: BAYSTATE HEALTH SYSTEM, INC. HEALTH BENEFITS PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	7,047
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	7,529
Total of all active and inactive participants	2015-01-01	7,529
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
2014: BAYSTATE HEALTH SYSTEM, INC. HEALTH BENEFITS PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	6,905
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	7,047
Total of all active and inactive participants	2014-01-01	7,047
Number of retired or separated participants receiving benefits	2014-01-01	0
Number of other retired or separated participants entitled to future benefits	2014-01-01	0
2013: BAYSTATE HEALTH SYSTEM, INC. HEALTH BENEFITS PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	6,900
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	6,905
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	6,905
2012: BAYSTATE HEALTH SYSTEM, INC. HEALTH BENEFITS PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	6,895
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	6,900
Number of retired or separated participants receiving benefits	2012-01-01	0
Number of other retired or separated participants entitled to future benefits	2012-01-01	0
Total of all active and inactive participants	2012-01-01	6,900
2011: BAYSTATE HEALTH SYSTEM, INC. HEALTH BENEFITS PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	7,020
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	6,895
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	6,895
2010: BAYSTATE HEALTH SYSTEM, INC. HEALTH BENEFITS PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	6,905
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	7,020
Number of retired or separated participants receiving benefits	2010-01-01	0
Number of other retired or separated participants entitled to future benefits	2010-01-01	0
Total of all active and inactive participants	2010-01-01	7,020
2009: BAYSTATE HEALTH SYSTEM, INC. HEALTH BENEFITS PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	6,859
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	6,905
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	6,905

Financial Data on BAYSTATE HEALTH SYSTEM, INC. HEALTH BENEFITS PLAN

Measure	Date	Value
2017 : BAYSTATE HEALTH SYSTEM, INC. HEALTH BENEFITS PLAN 2017 401k financial data
Total unrealized appreciation/depreciation of assets	2017-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-12-31	$1,617,942
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-12-31	$1,593,539
Total income from all sources (including contributions)	2017-12-31	$74,234,211
Total loss/gain on sale of assets	2017-12-31	$0
Total of all expenses incurred	2017-12-31	$74,563,431
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-12-31	$68,245,826
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2017-12-31	$74,234,211
Value of total assets at end of year	2017-12-31	$10,191,823
Value of total assets at beginning of year	2017-12-31	$10,496,640
Total of administrative expenses incurred including professional, contract, advisory and management fees	2017-12-31	$6,317,605
Total interest from all sources	2017-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2017-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2017-12-31	No
Was this plan covered by a fidelity bond	2017-12-31	Yes
Value of fidelity bond cover	2017-12-31	$5,000,000
Were there any nonexempt tranactions with any party-in-interest	2017-12-31	No
Contributions received from participants	2017-12-31	$21,495,710
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2017-12-31	$68,245,826
Value of other receiveables (less allowance for doubtful accounts) at end of year	2017-12-31	$1,600,000
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2017-12-31	$1,529,218
Administrative expenses (other) incurred	2017-12-31	$6,317,605
Liabilities. Value of operating payables at end of year	2017-12-31	$57,378
Liabilities. Value of operating payables at beginning of year	2017-12-31	$91,334
Total non interest bearing cash at end of year	2017-12-31	$0
Total non interest bearing cash at beginning of year	2017-12-31	$5,835,899
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2017-12-31	No
Value of net income/loss	2017-12-31	$-329,220
Value of net assets at end of year (total assets less liabilities)	2017-12-31	$8,573,881
Value of net assets at beginning of year (total assets less liabilities)	2017-12-31	$8,903,101
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2017-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2017-12-31	No
Were any leases to which the plan was party in default or uncollectible	2017-12-31	No
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2017-12-31	No
Was there a failure to transmit to the plan any participant contributions	2017-12-31	No
Has the plan failed to provide any benefit when due under the plan	2017-12-31	No
Contributions received in cash from employer	2017-12-31	$52,738,501
Employer contributions (assets) at end of year	2017-12-31	$8,591,823
Employer contributions (assets) at beginning of year	2017-12-31	$3,131,523
Liabilities. Value of benefit claims payable at end of year	2017-12-31	$1,560,564
Liabilities. Value of benefit claims payable at beginning of year	2017-12-31	$1,502,205
Did the plan have assets held for investment	2017-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2017-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2017-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2017-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2017-12-31	Disclaimer
Accountancy firm name	2017-12-31	MEYERS BROTHERS KALICKA P.C.
Accountancy firm EIN	2017-12-31	042713795
2016 : BAYSTATE HEALTH SYSTEM, INC. HEALTH BENEFITS PLAN 2016 401k financial data
Total unrealized appreciation/depreciation of assets	2016-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-12-31	$1,593,539
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-12-31	$2,246,307
Total income from all sources (including contributions)	2016-12-31	$87,474,794
Total loss/gain on sale of assets	2016-12-31	$0
Total of all expenses incurred	2016-12-31	$87,474,794
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-12-31	$79,343,071
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-12-31	$87,474,794
Value of total assets at end of year	2016-12-31	$10,496,640
Value of total assets at beginning of year	2016-12-31	$11,149,408
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-12-31	$8,131,723
Total interest from all sources	2016-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2016-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2016-12-31	No
Was this plan covered by a fidelity bond	2016-12-31	Yes
Value of fidelity bond cover	2016-12-31	$5,000,000
Were there any nonexempt tranactions with any party-in-interest	2016-12-31	No
Contributions received from participants	2016-12-31	$22,790,500
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2016-12-31	$79,343,071
Value of other receiveables (less allowance for doubtful accounts) at end of year	2016-12-31	$1,529,218
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2016-12-31	$2,900,317
Administrative expenses (other) incurred	2016-12-31	$8,131,723
Liabilities. Value of operating payables at end of year	2016-12-31	$91,334
Liabilities. Value of operating payables at beginning of year	2016-12-31	$129,517
Total non interest bearing cash at end of year	2016-12-31	$5,835,899
Total non interest bearing cash at beginning of year	2016-12-31	$6,687,964
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-12-31	No
Value of net income/loss	2016-12-31	$0
Value of net assets at end of year (total assets less liabilities)	2016-12-31	$8,903,101
Value of net assets at beginning of year (total assets less liabilities)	2016-12-31	$8,903,101
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2016-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2016-12-31	No
Were any leases to which the plan was party in default or uncollectible	2016-12-31	No
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2016-12-31	No
Was there a failure to transmit to the plan any participant contributions	2016-12-31	No
Has the plan failed to provide any benefit when due under the plan	2016-12-31	No
Contributions received in cash from employer	2016-12-31	$64,684,294
Employer contributions (assets) at end of year	2016-12-31	$3,131,523
Employer contributions (assets) at beginning of year	2016-12-31	$1,561,127
Liabilities. Value of benefit claims payable at end of year	2016-12-31	$1,502,205
Liabilities. Value of benefit claims payable at beginning of year	2016-12-31	$2,116,790
Did the plan have assets held for investment	2016-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2016-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2016-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2016-12-31	Disclaimer
Accountancy firm name	2016-12-31	MEYERS BROTHERS KALICKA P.C.
Accountancy firm EIN	2016-12-31	042713795
2015 : BAYSTATE HEALTH SYSTEM, INC. HEALTH BENEFITS PLAN 2015 401k financial data
Total unrealized appreciation/depreciation of assets	2015-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-12-31	$2,246,307
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-12-31	$2,083,904
Total income from all sources (including contributions)	2015-12-31	$77,976,003
Total loss/gain on sale of assets	2015-12-31	$0
Total of all expenses incurred	2015-12-31	$78,256,982
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-12-31	$71,342,415
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-12-31	$77,976,003
Value of total assets at end of year	2015-12-31	$11,149,408
Value of total assets at beginning of year	2015-12-31	$11,267,984
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-12-31	$6,914,567
Total interest from all sources	2015-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2015-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2015-12-31	No
Was this plan covered by a fidelity bond	2015-12-31	Yes
Value of fidelity bond cover	2015-12-31	$5,000,000
Were there any nonexempt tranactions with any party-in-interest	2015-12-31	No
Contributions received from participants	2015-12-31	$23,711,454
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2015-12-31	$71,342,415
Value of other receiveables (less allowance for doubtful accounts) at end of year	2015-12-31	$2,900,317
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2015-12-31	$2,577,900
Administrative expenses (other) incurred	2015-12-31	$6,914,567
Liabilities. Value of operating payables at end of year	2015-12-31	$129,517
Liabilities. Value of operating payables at beginning of year	2015-12-31	$118,379
Total non interest bearing cash at end of year	2015-12-31	$6,687,964
Total non interest bearing cash at beginning of year	2015-12-31	$8,205,196
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-12-31	No
Value of net income/loss	2015-12-31	$-280,979
Value of net assets at end of year (total assets less liabilities)	2015-12-31	$8,903,101
Value of net assets at beginning of year (total assets less liabilities)	2015-12-31	$9,184,080
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2015-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2015-12-31	No
Were any leases to which the plan was party in default or uncollectible	2015-12-31	No
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2015-12-31	No
Was there a failure to transmit to the plan any participant contributions	2015-12-31	No
Has the plan failed to provide any benefit when due under the plan	2015-12-31	No
Contributions received in cash from employer	2015-12-31	$54,264,549
Employer contributions (assets) at end of year	2015-12-31	$1,561,127
Employer contributions (assets) at beginning of year	2015-12-31	$484,888
Liabilities. Value of benefit claims payable at end of year	2015-12-31	$2,116,790
Liabilities. Value of benefit claims payable at beginning of year	2015-12-31	$1,965,525
Did the plan have assets held for investment	2015-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2015-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2015-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2015-12-31	Disclaimer
Accountancy firm name	2015-12-31	MEYERS BROTHERS KALICKA P.C.
Accountancy firm EIN	2015-12-31	042713795
2014 : BAYSTATE HEALTH SYSTEM, INC. HEALTH BENEFITS PLAN 2014 401k financial data
Total unrealized appreciation/depreciation of assets	2014-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-12-31	$2,083,904
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-12-31	$2,219,979
Total income from all sources (including contributions)	2014-12-31	$74,242,782
Total loss/gain on sale of assets	2014-12-31	$0
Total of all expenses incurred	2014-12-31	$73,632,585
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-12-31	$66,527,233
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-12-31	$74,242,782
Value of total assets at end of year	2014-12-31	$11,267,984
Value of total assets at beginning of year	2014-12-31	$10,793,862
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-12-31	$7,105,352
Total interest from all sources	2014-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2014-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2014-12-31	No
Was this plan covered by a fidelity bond	2014-12-31	Yes
Value of fidelity bond cover	2014-12-31	$5,000,000
Were there any nonexempt tranactions with any party-in-interest	2014-12-31	No
Contributions received from participants	2014-12-31	$21,343,401
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2014-12-31	$66,527,233
Value of other receiveables (less allowance for doubtful accounts) at end of year	2014-12-31	$610,198
Administrative expenses (other) incurred	2014-12-31	$7,105,352
Liabilities. Value of operating payables at end of year	2014-12-31	$118,379
Liabilities. Value of operating payables at beginning of year	2014-12-31	$209,485
Total non interest bearing cash at end of year	2014-12-31	$8,205,196
Total non interest bearing cash at beginning of year	2014-12-31	$7,555,376
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-12-31	No
Value of net income/loss	2014-12-31	$610,197
Value of net assets at end of year (total assets less liabilities)	2014-12-31	$9,184,080
Value of net assets at beginning of year (total assets less liabilities)	2014-12-31	$8,573,883
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2014-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2014-12-31	No
Were any leases to which the plan was party in default or uncollectible	2014-12-31	No
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2014-12-31	Yes
Was there a failure to transmit to the plan any participant contributions	2014-12-31	No
Has the plan failed to provide any benefit when due under the plan	2014-12-31	No
Contributions received in cash from employer	2014-12-31	$52,899,381
Employer contributions (assets) at end of year	2014-12-31	$2,452,590
Employer contributions (assets) at beginning of year	2014-12-31	$3,238,486
Liabilities. Value of benefit claims payable at end of year	2014-12-31	$1,965,525
Liabilities. Value of benefit claims payable at beginning of year	2014-12-31	$2,010,494
Did the plan have assets held for investment	2014-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2014-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2014-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2014-12-31	Disclaimer
Accountancy firm name	2014-12-31	MEYERS BROTHERS KALICKA P.C.
Accountancy firm EIN	2014-12-31	042713795
2013 : BAYSTATE HEALTH SYSTEM, INC. HEALTH BENEFITS PLAN 2013 401k financial data
Total unrealized appreciation/depreciation of assets	2013-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-12-31	$2,219,979
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-12-31	$3,167,560
Total income from all sources (including contributions)	2013-12-31	$73,048,161
Total loss/gain on sale of assets	2013-12-31	$0
Total of all expenses incurred	2013-12-31	$73,048,160
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2013-12-31	$66,655,924
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2013-12-31	$73,048,161
Value of total assets at end of year	2013-12-31	$10,793,862
Value of total assets at beginning of year	2013-12-31	$11,741,442
Total of administrative expenses incurred including professional, contract, advisory and management fees	2013-12-31	$6,392,236
Total interest from all sources	2013-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2013-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2013-12-31	No
Was this plan covered by a fidelity bond	2013-12-31	Yes
Value of fidelity bond cover	2013-12-31	$5,000,000
Were there any nonexempt tranactions with any party-in-interest	2013-12-31	No
Contributions received from participants	2013-12-31	$22,640,768
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2013-12-31	$66,655,924
Administrative expenses (other) incurred	2013-12-31	$6,392,236
Liabilities. Value of operating payables at end of year	2013-12-31	$209,485
Liabilities. Value of operating payables at beginning of year	2013-12-31	$161,429
Total non interest bearing cash at end of year	2013-12-31	$7,555,376
Total non interest bearing cash at beginning of year	2013-12-31	$8,573,882
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2013-12-31	No
Value of net income/loss	2013-12-31	$1
Value of net assets at end of year (total assets less liabilities)	2013-12-31	$8,573,883
Value of net assets at beginning of year (total assets less liabilities)	2013-12-31	$8,573,882
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2013-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2013-12-31	No
Were any leases to which the plan was party in default or uncollectible	2013-12-31	No
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2013-12-31	Yes
Was there a failure to transmit to the plan any participant contributions	2013-12-31	No
Has the plan failed to provide any benefit when due under the plan	2013-12-31	No
Contributions received in cash from employer	2013-12-31	$50,407,393
Employer contributions (assets) at end of year	2013-12-31	$3,238,486
Employer contributions (assets) at beginning of year	2013-12-31	$3,167,560
Liabilities. Value of benefit claims payable at end of year	2013-12-31	$2,010,494
Liabilities. Value of benefit claims payable at beginning of year	2013-12-31	$3,006,131
Did the plan have assets held for investment	2013-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2013-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2013-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2013-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2013-12-31	Disclaimer
Accountancy firm name	2013-12-31	MEYERS BROTHERS KALICKA, P.C.
Accountancy firm EIN	2013-12-31	042713795
2012 : BAYSTATE HEALTH SYSTEM, INC. HEALTH BENEFITS PLAN 2012 401k financial data
Total unrealized appreciation/depreciation of assets	2012-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-12-31	$3,167,560
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-12-31	$2,415,961
Total income from all sources (including contributions)	2012-12-31	$70,335,446
Total loss/gain on sale of assets	2012-12-31	$0
Total of all expenses incurred	2012-12-31	$69,976,319
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-12-31	$63,635,135
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-12-31	$70,335,446
Value of total assets at end of year	2012-12-31	$11,741,442
Value of total assets at beginning of year	2012-12-31	$10,630,716
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-12-31	$6,341,184
Total interest from all sources	2012-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2012-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2012-12-31	No
Was this plan covered by a fidelity bond	2012-12-31	Yes
Value of fidelity bond cover	2012-12-31	$5,000,000
Were there any nonexempt tranactions with any party-in-interest	2012-12-31	No
Contributions received from participants	2012-12-31	$23,260,194
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2012-12-31	$63,635,135
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2012-12-31	$48,549
Administrative expenses (other) incurred	2012-12-31	$6,341,184
Liabilities. Value of operating payables at end of year	2012-12-31	$161,429
Liabilities. Value of operating payables at beginning of year	2012-12-31	$199,443
Total non interest bearing cash at end of year	2012-12-31	$8,573,882
Total non interest bearing cash at beginning of year	2012-12-31	$5,280,800
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-12-31	No
Value of net income/loss	2012-12-31	$359,127
Value of net assets at end of year (total assets less liabilities)	2012-12-31	$8,573,882
Value of net assets at beginning of year (total assets less liabilities)	2012-12-31	$8,214,755
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2012-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2012-12-31	No
Were any leases to which the plan was party in default or uncollectible	2012-12-31	No
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2012-12-31	Yes
Was there a failure to transmit to the plan any participant contributions	2012-12-31	No
Has the plan failed to provide any benefit when due under the plan	2012-12-31	No
Contributions received in cash from employer	2012-12-31	$47,075,252
Employer contributions (assets) at end of year	2012-12-31	$3,167,560
Employer contributions (assets) at beginning of year	2012-12-31	$5,301,367
Liabilities. Value of benefit claims payable at end of year	2012-12-31	$3,006,131
Liabilities. Value of benefit claims payable at beginning of year	2012-12-31	$2,216,518
Did the plan have assets held for investment	2012-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2012-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2012-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2012-12-31	Disclaimer
Accountancy firm name	2012-12-31	MEYERS BROTHERS KALICKA, P.C.
Accountancy firm EIN	2012-12-31	042713795
2011 : BAYSTATE HEALTH SYSTEM, INC. HEALTH BENEFITS PLAN 2011 401k financial data
Total unrealized appreciation/depreciation of assets	2011-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-12-31	$2,415,961
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-12-31	$2,154,682
Total income from all sources (including contributions)	2011-12-31	$77,632,297
Total loss/gain on sale of assets	2011-12-31	$0
Total of all expenses incurred	2011-12-31	$77,752,581
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-12-31	$70,706,600
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-12-31	$77,632,297
Value of total assets at end of year	2011-12-31	$10,630,716
Value of total assets at beginning of year	2011-12-31	$10,489,721
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-12-31	$7,045,981
Total interest from all sources	2011-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2011-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2011-12-31	No
Was this plan covered by a fidelity bond	2011-12-31	Yes
Value of fidelity bond cover	2011-12-31	$5,000,000
Were there any nonexempt tranactions with any party-in-interest	2011-12-31	No
Contributions received from participants	2011-12-31	$25,468,901
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2011-12-31	$70,706,600
Value of other receiveables (less allowance for doubtful accounts) at end of year	2011-12-31	$48,549
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2011-12-31	$217,492
Administrative expenses (other) incurred	2011-12-31	$7,045,981
Liabilities. Value of operating payables at end of year	2011-12-31	$199,443
Liabilities. Value of operating payables at beginning of year	2011-12-31	$123,530
Total non interest bearing cash at end of year	2011-12-31	$5,280,800
Total non interest bearing cash at beginning of year	2011-12-31	$8,117,547
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-12-31	No
Value of net income/loss	2011-12-31	$-120,284
Value of net assets at end of year (total assets less liabilities)	2011-12-31	$8,214,755
Value of net assets at beginning of year (total assets less liabilities)	2011-12-31	$8,335,039
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2011-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2011-12-31	No
Were any leases to which the plan was party in default or uncollectible	2011-12-31	No
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2011-12-31	Yes
Was there a failure to transmit to the plan any participant contributions	2011-12-31	No
Has the plan failed to provide any benefit when due under the plan	2011-12-31	No
Contributions received in cash from employer	2011-12-31	$52,163,396
Employer contributions (assets) at end of year	2011-12-31	$5,301,367
Employer contributions (assets) at beginning of year	2011-12-31	$2,154,682
Liabilities. Value of benefit claims payable at end of year	2011-12-31	$2,216,518
Liabilities. Value of benefit claims payable at beginning of year	2011-12-31	$2,031,152
Did the plan have assets held for investment	2011-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2011-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2011-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2011-12-31	Disclaimer
Accountancy firm name	2011-12-31	MEYERS BROTHERS KALICKA, P.C.
Accountancy firm EIN	2011-12-31	042713795
2010 : BAYSTATE HEALTH SYSTEM, INC. HEALTH BENEFITS PLAN 2010 401k financial data
Total unrealized appreciation/depreciation of assets	2010-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2010-12-31	$2,154,682
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2010-12-31	$2,255,257
Total income from all sources (including contributions)	2010-12-31	$72,667,147
Total loss/gain on sale of assets	2010-12-31	$0
Total of all expenses incurred	2010-12-31	$72,083,609
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2010-12-31	$65,207,518
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2010-12-31	$72,666,241
Value of total assets at end of year	2010-12-31	$10,489,721
Value of total assets at beginning of year	2010-12-31	$10,006,758
Total of administrative expenses incurred including professional, contract, advisory and management fees	2010-12-31	$6,876,091
Total interest from all sources	2010-12-31	$906
Total dividends received (eg from common stock, registered investment company shares)	2010-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2010-12-31	No
Was this plan covered by a fidelity bond	2010-12-31	Yes
Value of fidelity bond cover	2010-12-31	$5,000,000
Were there any nonexempt tranactions with any party-in-interest	2010-12-31	No
Contributions received from participants	2010-12-31	$24,696,569
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2010-12-31	$65,207,518
Value of other receiveables (less allowance for doubtful accounts) at end of year	2010-12-31	$217,492
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2010-12-31	$450,000
Administrative expenses (other) incurred	2010-12-31	$6,876,091
Liabilities. Value of operating payables at end of year	2010-12-31	$123,530
Liabilities. Value of operating payables at beginning of year	2010-12-31	$226,326
Total non interest bearing cash at end of year	2010-12-31	$8,117,547
Total non interest bearing cash at beginning of year	2010-12-31	$4,441,549
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2010-12-31	No
Value of net income/loss	2010-12-31	$583,538
Value of net assets at end of year (total assets less liabilities)	2010-12-31	$8,335,039
Value of net assets at beginning of year (total assets less liabilities)	2010-12-31	$7,751,501
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2010-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2010-12-31	No
Were any leases to which the plan was party in default or uncollectible	2010-12-31	No
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2010-12-31	$906
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2010-12-31	Yes
Was there a failure to transmit to the plan any participant contributions	2010-12-31	No
Has the plan failed to provide any benefit when due under the plan	2010-12-31	No
Contributions received in cash from employer	2010-12-31	$47,969,672
Employer contributions (assets) at end of year	2010-12-31	$2,154,682
Employer contributions (assets) at beginning of year	2010-12-31	$5,115,209
Liabilities. Value of benefit claims payable at end of year	2010-12-31	$2,031,152
Liabilities. Value of benefit claims payable at beginning of year	2010-12-31	$2,028,931
Did the plan have assets held for investment	2010-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2010-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2010-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2010-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2010-12-31	Disclaimer
Accountancy firm name	2010-12-31	MEYERS BROTHERS KALICKA, P.C.
Accountancy firm EIN	2010-12-31	042713795

Form 5500 Responses for BAYSTATE HEALTH SYSTEM, INC. HEALTH BENEFITS PLAN

2022: BAYSTATE HEALTH SYSTEM, INC. HEALTH BENEFITS PLAN 2022 form 5500 responses
2022-01-01	Type of plan entity	Single employer plan
2022-01-01	Submission has been amended	No
2022-01-01	This submission is the final filing	No
2022-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2022-01-01	Plan is a collectively bargained plan	No
2022-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2022-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2021: BAYSTATE HEALTH SYSTEM, INC. HEALTH BENEFITS PLAN 2021 form 5500 responses
2021-01-01	Type of plan entity	Single employer plan
2021-01-01	Submission has been amended	No
2021-01-01	This submission is the final filing	No
2021-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2021-01-01	Plan is a collectively bargained plan	No
2021-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2021-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2020: BAYSTATE HEALTH SYSTEM, INC. HEALTH BENEFITS 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 – General assets of the sponsor	Yes
2020-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2019: BAYSTATE HEALTH SYSTEM, INC. HEALTH BENEFITS PLAN 2019 form 5500 responses
2019-01-01	Type of plan entity	Single employer plan
2019-01-01	Submission has been amended	No
2019-01-01	This submission is the final filing	No
2019-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2019-01-01	Plan is a collectively bargained plan	No
2019-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2019-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2018: BAYSTATE HEALTH SYSTEM, INC. HEALTH BENEFITS PLAN 2018 form 5500 responses
2018-01-01	Type of plan entity	Single employer plan
2018-01-01	Submission has been amended	No
2018-01-01	This submission is the final filing	No
2018-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2018-01-01	Plan is a collectively bargained plan	No
2018-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2018-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2017: BAYSTATE HEALTH SYSTEM, INC. HEALTH BENEFITS PLAN 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	Submission has been amended	No
2017-01-01	This submission is the final filing	No
2017-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2017-01-01	Plan is a collectively bargained plan	No
2017-01-01	Plan funding arrangement – Insurance	Yes
2017-01-01	Plan funding arrangement – Trust	Yes
2017-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2017-01-01	Plan benefit arrangement – Insurance	Yes
2017-01-01	Plan benefit arrangement - Trust	Yes
2017-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2016: BAYSTATE HEALTH SYSTEM, INC. HEALTH BENEFITS PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Submission has been amended	No
2016-01-01	This submission is the final filing	No
2016-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-01-01	Plan is a collectively bargained plan	No
2016-01-01	Plan funding arrangement – Insurance	Yes
2016-01-01	Plan funding arrangement – Trust	Yes
2016-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2016-01-01	Plan benefit arrangement – Insurance	Yes
2016-01-01	Plan benefit arrangement - Trust	Yes
2016-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2015: BAYSTATE HEALTH SYSTEM, INC. HEALTH BENEFITS PLAN 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	No
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 – Trust	Yes
2015-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2015-01-01	Plan benefit arrangement - Trust	Yes
2015-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2014: BAYSTATE HEALTH SYSTEM, INC. HEALTH 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 – Trust	Yes
2014-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2014-01-01	Plan benefit arrangement - Trust	Yes
2014-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2013: BAYSTATE HEALTH SYSTEM, INC. HEALTH 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 – Trust	Yes
2013-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2013-01-01	Plan benefit arrangement - Trust	Yes
2013-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2012: BAYSTATE HEALTH SYSTEM, INC. HEALTH 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 – Trust	Yes
2012-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2012-01-01	Plan benefit arrangement - Trust	Yes
2012-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2011: BAYSTATE HEALTH SYSTEM, INC. HEALTH BENEFITS PLAN 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 – Trust	Yes
2011-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2011-01-01	Plan benefit arrangement - Trust	Yes
2011-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2010: BAYSTATE HEALTH SYSTEM, INC. HEALTH BENEFITS PLAN 2010 form 5500 responses
2010-01-01	Type of plan entity	Single employer plan
2010-01-01	Submission has been amended	No
2010-01-01	This submission is the final filing	No
2010-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2010-01-01	Plan is a collectively bargained plan	No
2010-01-01	Plan funding arrangement – Trust	Yes
2010-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2010-01-01	Plan benefit arrangement - Trust	Yes
2010-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2009: BAYSTATE HEALTH SYSTEM, INC. HEALTH BENEFITS PLAN 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 – Trust	Yes
2009-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2009-01-01	Plan benefit arrangement - Trust	Yes
2009-01-01	Plan benefit arrangement – General assets of the sponsor	Yes

Insurance Providers Used on plan

HM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93440 )

Policy contract number

4039330010

Policy instance

Insurance contract or identification number	4039330010
Number of Individuals Covered	7454
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $31,631
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	No
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 $581,477
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $31,631
Insurance broker organization code?	3
Insurance broker name	HNE INSURANCE SERVICES CORP.

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Company Name:	BAYSTATE HEALTH, INC.
Employer identification number (EIN):	042105941
NAIC Classification:	622000
NAIC Description:	Hospitals