401k Plan data: EMPLOYEE FLEXIBLE SPENDING ACCOUNT PLAN plan

EMPLOYEE FLEXIBLE SPENDING ACCOUNT PLAN 401k Plan overview

Plan Name	EMPLOYEE FLEXIBLE SPENDING ACCOUNT PLAN
Plan identification number	508

EMPLOYEE FLEXIBLE SPENDING ACCOUNT PLAN Benefits

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

401k Sponsoring company profile

INSPIRA MEDICAL CENTER - WOODBURY has sponsored the creation of one or more 401k plans.

Company Name: INSPIRA MEDICAL CENTER - WOODBURY

Employer identification number (EIN): 221820210

NAIC Classification: 622000
NAIC Description: Hospitals

Form 5500 Filing Information

Submission information for form 5500 for 401k plan EMPLOYEE FLEXIBLE SPENDING ACCOUNT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
508 2014-01-01 KIM L SCHWINDT
508 2013-01-01 KIM L SCHWINDT
508 2012-01-01 JOHN W GRAHAM
508 2011-01-01 JOHN W. GRAHAM
508 2010-01-01 JOHN W GRAHAM
508 2009-01-01 JOHN GRAHAM

Plan id#	Filing Submission Date	Name of Administrator
508	2014-01-01	KIM L SCHWINDT
508	2013-01-01	KIM L SCHWINDT
508	2012-01-01	JOHN W GRAHAM
508	2011-01-01	JOHN W. GRAHAM
508	2010-01-01	JOHN W GRAHAM
508	2009-01-01	JOHN GRAHAM

Plan Statistics for EMPLOYEE FLEXIBLE SPENDING ACCOUNT PLAN

401k plan membership statisitcs for EMPLOYEE FLEXIBLE SPENDING ACCOUNT PLAN

Measure Date Value
2014: EMPLOYEE FLEXIBLE SPENDING ACCOUNT PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 120
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 0
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
Total of all active and inactive participants 2014-01-01 0
2013: EMPLOYEE FLEXIBLE SPENDING ACCOUNT PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 145
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 120
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 2013-01-01 120
2012: EMPLOYEE FLEXIBLE SPENDING ACCOUNT PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 137
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 145
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 2012-01-01 145
2011: EMPLOYEE FLEXIBLE SPENDING ACCOUNT PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 109
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 137
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 2011-01-01 137
2010: EMPLOYEE FLEXIBLE SPENDING ACCOUNT PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 118
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 109
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 2010-01-01 109
2009: EMPLOYEE FLEXIBLE SPENDING ACCOUNT PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 121
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 118
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 2009-01-01 118

Measure	Date	Value
2014: EMPLOYEE FLEXIBLE SPENDING ACCOUNT PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	120
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	0
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
Total of all active and inactive participants	2014-01-01	0
2013: EMPLOYEE FLEXIBLE SPENDING ACCOUNT PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	145
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	120
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	120
2012: EMPLOYEE FLEXIBLE SPENDING ACCOUNT PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	137
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	145
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	145
2011: EMPLOYEE FLEXIBLE SPENDING ACCOUNT PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	109
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	137
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	137
2010: EMPLOYEE FLEXIBLE SPENDING ACCOUNT PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	118
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	109
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	109
2009: EMPLOYEE FLEXIBLE SPENDING ACCOUNT PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	121
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	118
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	118

Form 5500 Responses for EMPLOYEE FLEXIBLE SPENDING ACCOUNT PLAN

2014: EMPLOYEE FLEXIBLE SPENDING ACCOUNT 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	Yes
2014-01-01	This return/report is a short plan year return/report (less than 12 months)	Yes
2014-01-01	Plan is a collectively bargained plan	No
2014-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2014-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2013: EMPLOYEE FLEXIBLE SPENDING ACCOUNT 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 – General assets of the sponsor	Yes
2013-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2012: EMPLOYEE FLEXIBLE SPENDING ACCOUNT 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 – General assets of the sponsor	Yes
2012-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2011: EMPLOYEE FLEXIBLE SPENDING ACCOUNT 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 – General assets of the sponsor	Yes
2011-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2010: EMPLOYEE FLEXIBLE SPENDING ACCOUNT 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 – General assets of the sponsor	Yes
2010-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2009: EMPLOYEE FLEXIBLE SPENDING ACCOUNT 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 – General assets of the sponsor	Yes
2009-01-01	Plan benefit arrangement – General assets of the sponsor	Yes

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Company Name:	INSPIRA MEDICAL CENTER - WOODBURY
Employer identification number (EIN):	221820210
NAIC Classification:	622000
NAIC Description:	Hospitals