401k Plan data: DAVIS VISION plan

DAVIS VISION 401k Plan overview

Plan Name	DAVIS VISION
Plan identification number	537

DAVIS VISION Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Vision

401k Sponsoring company profile

NORTHEAST HEALTH has sponsored the creation of one or more 401k plans.

Company Name: NORTHEAST HEALTH

Employer identification number (EIN): 042450756

NAIC Classification: 622000
NAIC Description: Hospitals

Form 5500 Filing Information

Submission information for form 5500 for 401k plan DAVIS VISION

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
537 2012-01-01 BARBARA MCCANDLESS
537 2011-01-01 BARBARA MCCANDLESS
537 2010-01-01 BARBARA MCCANDLESS

Plan id#	Filing Submission Date	Name of Administrator
537	2012-01-01	BARBARA MCCANDLESS
537	2011-01-01	BARBARA MCCANDLESS
537	2010-01-01	BARBARA MCCANDLESS

Plan Statistics for DAVIS VISION

401k plan membership statisitcs for DAVIS VISION

Measure Date Value
2012: DAVIS VISION 2012 401k membership
Total participants, beginning-of-year 2012-01-01 1,288
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 0
Total of all active and inactive participants 2012-01-01 0
Total participants 2012-01-01 0
2011: DAVIS VISION 2011 401k membership
Total participants, beginning-of-year 2011-01-01 1,346
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 1,288
Total of all active and inactive participants 2011-01-01 1,288
Total participants 2011-01-01 1,288
2010: DAVIS VISION 2010 401k membership
Total participants, beginning-of-year 2010-01-01 1,346
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 1,346
Total of all active and inactive participants 2010-01-01 1,346
Total participants 2010-01-01 1,346

Measure	Date	Value
2012: DAVIS VISION 2012 401k membership
Total participants, beginning-of-year	2012-01-01	1,288
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	0
Total of all active and inactive participants	2012-01-01	0
Total participants	2012-01-01	0
2011: DAVIS VISION 2011 401k membership
Total participants, beginning-of-year	2011-01-01	1,346
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	1,288
Total of all active and inactive participants	2011-01-01	1,288
Total participants	2011-01-01	1,288
2010: DAVIS VISION 2010 401k membership
Total participants, beginning-of-year	2010-01-01	1,346
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	1,346
Total of all active and inactive participants	2010-01-01	1,346
Total participants	2010-01-01	1,346

Form 5500 Responses for DAVIS VISION

2012: DAVIS VISION 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	Yes
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: DAVIS VISION 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: DAVIS VISION 2010 form 5500 responses
2010-01-01	Type of plan entity	Single employer plan
2010-01-01	First time form 5500 has been submitted	Yes
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 – Insurance	Yes
2010-01-01	Plan benefit arrangement – Insurance	Yes

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Company Name:	NORTHEAST HEALTH
Employer identification number (EIN):	042450756
NAIC Classification:	622000
NAIC Description:	Hospitals