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ADVANCED ICU CARE, INC. HEALTH INSURANCE PLAN 401k Plan overview

Plan NameADVANCED ICU CARE, INC. HEALTH INSURANCE PLAN
Plan identification number 502

ADVANCED ICU CARE, INC. HEALTH INSURANCE PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Dental
  • Vision

401k Sponsoring company profile

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

Company Name:HICUITY HEALTH, INC.
Employer identification number (EIN):364584776
NAIC Classification:621111
NAIC Description:Offices of Physicians (except Mental Health Specialists)

Form 5500 Filing Information

Submission information for form 5500 for 401k plan ADVANCED ICU CARE, INC. HEALTH INSURANCE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5022017-01-01ANDREA CLEGG ANDREA CLEGG2018-10-11
5022017-01-01
5022016-01-01
5022016-01-01 ANDREA CLEGG2017-10-16
5022015-11-01ANDREA CLEGG ANDREA CLEGG2016-04-13
5022015-11-01
5022014-11-01ANDREA CLEGG ANDREA CLEGG2016-04-08
5022014-11-01
5022013-11-01
5022012-11-01
5022011-11-01
5022010-11-01

Plan Statistics for ADVANCED ICU CARE, INC. HEALTH INSURANCE PLAN

401k plan membership statisitcs for ADVANCED ICU CARE, INC. HEALTH INSURANCE PLAN

Measure Date Value
2017: ADVANCED ICU CARE, INC. HEALTH INSURANCE PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-01168
Total number of active participants reported on line 7a of the Form 55002017-01-01167
Number of retired or separated participants receiving benefits2017-01-011
Total of all active and inactive participants2017-01-01168
2016: ADVANCED ICU CARE, INC. HEALTH INSURANCE PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-01172
Total number of active participants reported on line 7a of the Form 55002016-01-01162
Number of retired or separated participants receiving benefits2016-01-016
Total of all active and inactive participants2016-01-01168
Total participants2016-01-01168
2015: ADVANCED ICU CARE, INC. HEALTH INSURANCE PLAN 2015 401k membership
Total participants, beginning-of-year2015-11-01168
Total number of active participants reported on line 7a of the Form 55002015-11-01167
Number of retired or separated participants receiving benefits2015-11-015
Number of other retired or separated participants entitled to future benefits2015-11-010
Total of all active and inactive participants2015-11-01172
Total participants2015-11-01172
2014: ADVANCED ICU CARE, INC. HEALTH INSURANCE PLAN 2014 401k membership
Total participants, beginning-of-year2014-11-01290
Total number of active participants reported on line 7a of the Form 55002014-11-01163
Number of retired or separated participants receiving benefits2014-11-015
Total of all active and inactive participants2014-11-01168
Total participants2014-11-01168
2013: ADVANCED ICU CARE, INC. HEALTH INSURANCE PLAN 2013 401k membership
Total participants, beginning-of-year2013-11-0198
Total number of active participants reported on line 7a of the Form 55002013-11-01136
Number of retired or separated participants receiving benefits2013-11-010
Number of other retired or separated participants entitled to future benefits2013-11-012
Total of all active and inactive participants2013-11-01138
Total participants2013-11-01138
2012: ADVANCED ICU CARE, INC. HEALTH INSURANCE PLAN 2012 401k membership
Total participants, beginning-of-year2012-11-0189
Total number of active participants reported on line 7a of the Form 55002012-11-0198
Number of retired or separated participants receiving benefits2012-11-010
Number of other retired or separated participants entitled to future benefits2012-11-010
Total of all active and inactive participants2012-11-0198
Total participants2012-11-0198
2011: ADVANCED ICU CARE, INC. HEALTH INSURANCE PLAN 2011 401k membership
Total participants, beginning-of-year2011-11-0172
Total number of active participants reported on line 7a of the Form 55002011-11-0189
Number of retired or separated participants receiving benefits2011-11-010
Number of other retired or separated participants entitled to future benefits2011-11-010
Total of all active and inactive participants2011-11-0189
Total participants2011-11-0189
2010: ADVANCED ICU CARE, INC. HEALTH INSURANCE PLAN 2010 401k membership
Total participants, beginning-of-year2010-11-0172
Total number of active participants reported on line 7a of the Form 55002010-11-0172
Number of retired or separated participants receiving benefits2010-11-010
Number of other retired or separated participants entitled to future benefits2010-11-010
Total of all active and inactive participants2010-11-0172
Total participants2010-11-0172

Form 5500 Responses for ADVANCED ICU CARE, INC. HEALTH INSURANCE PLAN

2017: ADVANCED ICU CARE, INC. HEALTH INSURANCE PLAN 2017 form 5500 responses
2017-01-01Type of plan entityMulitple employer plan
2017-01-01Submission has been amendedNo
2017-01-01This submission is the final filingNo
2017-01-01This return/report is a short plan year return/report (less than 12 months)No
2017-01-01Plan is a collectively bargained planNo
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan benefit arrangement – InsuranceYes
2016: ADVANCED ICU CARE, INC. HEALTH INSURANCE PLAN 2016 form 5500 responses
2016-01-01Type of plan entityMulitple employer plan
2016-01-01Submission has been amendedYes
2016-01-01This submission is the final filingNo
2016-01-01This return/report is a short plan year return/report (less than 12 months)No
2016-01-01Plan is a collectively bargained planNo
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan benefit arrangement – InsuranceYes
2015: ADVANCED ICU CARE, INC. HEALTH INSURANCE PLAN 2015 form 5500 responses
2015-11-01Type of plan entitySingle employer plan
2015-11-01Submission has been amendedNo
2015-11-01This submission is the final filingNo
2015-11-01This return/report is a short plan year return/report (less than 12 months)Yes
2015-11-01Plan is a collectively bargained planNo
2015-11-01Plan funding arrangement – InsuranceYes
2015-11-01Plan benefit arrangement – InsuranceYes
2014: ADVANCED ICU CARE, INC. HEALTH INSURANCE PLAN 2014 form 5500 responses
2014-11-01Type of plan entityMulitple employer plan
2014-11-01Submission has been amendedYes
2014-11-01This submission is the final filingNo
2014-11-01This return/report is a short plan year return/report (less than 12 months)No
2014-11-01Plan is a collectively bargained planNo
2014-11-01Plan funding arrangement – InsuranceYes
2014-11-01Plan benefit arrangement – InsuranceYes
2013: ADVANCED ICU CARE, INC. HEALTH INSURANCE PLAN 2013 form 5500 responses
2013-11-01Type of plan entityMulitple employer plan
2013-11-01Submission has been amendedYes
2013-11-01This submission is the final filingNo
2013-11-01This return/report is a short plan year return/report (less than 12 months)No
2013-11-01Plan is a collectively bargained planNo
2013-11-01Plan funding arrangement – InsuranceYes
2013-11-01Plan funding arrangement – General assets of the sponsorYes
2013-11-01Plan benefit arrangement – InsuranceYes
2013-11-01Plan benefit arrangement – General assets of the sponsorYes
2012: ADVANCED ICU CARE, INC. HEALTH INSURANCE PLAN 2012 form 5500 responses
2012-11-01Type of plan entityMulitple employer plan
2012-11-01Submission has been amendedNo
2012-11-01This submission is the final filingNo
2012-11-01This return/report is a short plan year return/report (less than 12 months)No
2012-11-01Plan is a collectively bargained planNo
2012-11-01Plan funding arrangement – InsuranceYes
2012-11-01Plan funding arrangement – General assets of the sponsorYes
2012-11-01Plan benefit arrangement – InsuranceYes
2012-11-01Plan benefit arrangement – General assets of the sponsorYes
2011: ADVANCED ICU CARE, INC. HEALTH INSURANCE PLAN 2011 form 5500 responses
2011-11-01Type of plan entityMulitple employer plan
2011-11-01Submission has been amendedNo
2011-11-01This submission is the final filingNo
2011-11-01This return/report is a short plan year return/report (less than 12 months)No
2011-11-01Plan is a collectively bargained planNo
2011-11-01Plan funding arrangement – InsuranceYes
2011-11-01Plan funding arrangement – General assets of the sponsorYes
2011-11-01Plan benefit arrangement – InsuranceYes
2011-11-01Plan benefit arrangement – General assets of the sponsorYes
2010: ADVANCED ICU CARE, INC. HEALTH INSURANCE PLAN 2010 form 5500 responses
2010-11-01Type of plan entityMulitple employer plan
2010-11-01First time form 5500 has been submittedYes
2010-11-01Submission has been amendedNo
2010-11-01This submission is the final filingNo
2010-11-01This return/report is a short plan year return/report (less than 12 months)No
2010-11-01Plan is a collectively bargained planNo
2010-11-01Plan funding arrangement – InsuranceYes
2010-11-01Plan funding arrangement – General assets of the sponsorYes
2010-11-01Plan benefit arrangement – InsuranceYes
2010-11-01Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

HEALTHY ALLIANCE LIFE INSURANCE COMPANY (G0262) (National Association of Insurance Commissioners NAIC id number: 78972 )
Policy contract number00246497
Policy instance 1
Insurance contract or identification number00246497
Number of Individuals Covered167
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $62,903
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,694,499
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $62,922
Insurance broker organization code?3
Insurance broker nameASSURED PARTNERS OF MISSOURI LLC
HEALTHY ALLIANCE LIFE INSURANCE COMPANY (G0262) (National Association of Insurance Commissioners NAIC id number: 78972 )
Policy contract number401028
Policy instance 2
Insurance contract or identification number401028
Number of Individuals Covered155
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $130,936
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HEALTHY ALLIANCE LIFE INSURANCE COMPANY (G0262) (National Association of Insurance Commissioners NAIC id number: 78972 )
Policy contract number00246497
Policy instance 1
Insurance contract or identification number00246497
Number of Individuals Covered167
Insurance policy start date2015-11-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $10,281
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $121,321
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $10,281
Insurance broker organization code?3
Insurance broker nameASSURED PARTNERS OF MISSOURI, LLC
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number0903438
Policy instance 1
Insurance contract or identification number0903438
Number of Individuals Covered163
Insurance policy start date2014-11-01
Insurance policy end date2015-10-31
Total amount of commissions paid to insurance brokerUSD $4,904
Total amount of fees paid to insurance companyUSD $57,576
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,244,702
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,904
Amount paid for insurance broker fees57576
Additional information about fees paid to insurance brokerSERVICE FEE
Insurance broker organization code?3
Insurance broker nameASSURED PARTNERS OF MISSOURI LLC
DELTA DENTAL OF MISSOURI (National Association of Insurance Commissioners NAIC id number: 55697 )
Policy contract number19501388
Policy instance 2
Insurance contract or identification number19501388
Number of Individuals Covered304
Insurance policy start date2014-11-01
Insurance policy end date2015-10-31
Total amount of commissions paid to insurance brokerUSD $18,009
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $162,438
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,176
Amount paid for insurance broker fees0
Insurance broker organization code?3
Insurance broker nameASSURED PARTNERS OF MISSOURI LLC
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number549731
Policy instance 1
Insurance contract or identification number549731
Number of Individuals Covered288
Insurance policy start date2013-11-01
Insurance policy end date2014-10-31
Total amount of commissions paid to insurance brokerUSD $45,849
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $900,133
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $45,849
Insurance broker organization code?3
Insurance broker nameAHM FINANCIAL GROUP LLC

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