401k Plan data: EDS SERVICE SOLUTIONS, INC SAN FRANCISCO MEDICAL PLAN plan

EDS SERVICE SOLUTIONS, INC SAN FRANCISCO MEDICAL PLAN 401k Plan overview

Plan Name	EDS SERVICE SOLUTIONS, INC SAN FRANCISCO MEDICAL PLAN
Plan identification number	501

EDS SERVICE SOLUTIONS, INC SAN FRANCISCO MEDICAL PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) Unfunded, fully insured, or combination unfunded/insured welfare plan that will not file a Form 5500 for next plan year pursuant to 29 CFR 2520.104-20. Unfunded, fully insured, or combination unfunded/insured welfare plan that stopped filing form 5500s in an earlier plan year pursuant to 29 CFR 2520.104-20.

401k Sponsoring company profile

EDS SERVICE SOLUTIONS, LLC. has sponsored the creation of one or more 401k plans.

Company Name: EDS SERVICE SOLUTIONS, LLC.

Employer identification number (EIN): 471900711

NAIC Classification: 561300

Form 5500 Filing Information

Submission information for form 5500 for 401k plan EDS SERVICE SOLUTIONS, INC SAN FRANCISCO MEDICAL PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2023-01-01 GABRIELA RADER 2024-09-23
501 2022-01-01 GABRIELA RADER 2023-07-19
501 2021-01-01 GABRIELA RADER 2022-07-19
501 2020-01-01 GABRIELA RADER 2021-08-05
501 2019-01-01 GABRIELA RADER 2020-10-02
501 2018-01-01
501 2017-01-01

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
501	2023-01-01	GABRIELA RADER	2024-09-23
501	2022-01-01	GABRIELA RADER	2023-07-19
501	2021-01-01	GABRIELA RADER	2022-07-19
501	2020-01-01	GABRIELA RADER	2021-08-05
501	2019-01-01	GABRIELA RADER	2020-10-02
501	2018-01-01
501	2017-01-01

Plan Statistics for EDS SERVICE SOLUTIONS, INC SAN FRANCISCO MEDICAL PLAN

401k plan membership statisitcs for EDS SERVICE SOLUTIONS, INC SAN FRANCISCO MEDICAL PLAN

Measure Date Value
2023: EDS SERVICE SOLUTIONS, INC SAN FRANCISCO MEDICAL PLAN 2023 401k membership
Total participants, beginning-of-year 2023-01-01 49
Total number of active participants reported on line 7a of the Form 5500 2023-01-01 44
Number of retired or separated participants receiving benefits 2023-01-01 0
Number of other retired or separated participants entitled to future benefits 2023-01-01 0
Total of all active and inactive participants 2023-01-01 44
Number of employers contributing to the scheme 2023-01-01 0
2022: EDS SERVICE SOLUTIONS, INC SAN FRANCISCO MEDICAL PLAN 2022 401k membership
Total participants, beginning-of-year 2022-01-01 30
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 50
Number of retired or separated participants receiving benefits 2022-01-01 0
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 50
Number of employers contributing to the scheme 2022-01-01 0
2021: EDS SERVICE SOLUTIONS, INC SAN FRANCISCO MEDICAL PLAN 2021 401k membership
Total participants, beginning-of-year 2021-01-01 19
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 33
Number of retired or separated participants receiving benefits 2021-01-01 0
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 33
Number of employers contributing to the scheme 2021-01-01 0
2020: EDS SERVICE SOLUTIONS, INC SAN FRANCISCO MEDICAL PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 109
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 19
Number of retired or separated participants receiving benefits 2020-01-01 0
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 19
Number of employers contributing to the scheme 2020-01-01 0
2019: EDS SERVICE SOLUTIONS, INC SAN FRANCISCO MEDICAL PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 120
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 124
Number of retired or separated participants receiving benefits 2019-01-01 0
Number of other retired or separated participants entitled to future benefits 2019-01-01 0
Total of all active and inactive participants 2019-01-01 124
Number of employers contributing to the scheme 2019-01-01 0
2018: EDS SERVICE SOLUTIONS, INC SAN FRANCISCO MEDICAL PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 110
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 94
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 94
Number of employers contributing to the scheme 2018-01-01 0
2017: EDS SERVICE SOLUTIONS, INC SAN FRANCISCO MEDICAL PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 101
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 102
Number of retired or separated participants receiving benefits 2017-01-01 0
Number of other retired or separated participants entitled to future benefits 2017-01-01 0
Total of all active and inactive participants 2017-01-01 102

Measure	Date	Value
2023: EDS SERVICE SOLUTIONS, INC SAN FRANCISCO MEDICAL PLAN 2023 401k membership
Total participants, beginning-of-year	2023-01-01	49
Total number of active participants reported on line 7a of the Form 5500	2023-01-01	44
Number of retired or separated participants receiving benefits	2023-01-01	0
Number of other retired or separated participants entitled to future benefits	2023-01-01	0
Total of all active and inactive participants	2023-01-01	44
Number of employers contributing to the scheme	2023-01-01	0
2022: EDS SERVICE SOLUTIONS, INC SAN FRANCISCO MEDICAL PLAN 2022 401k membership
Total participants, beginning-of-year	2022-01-01	30
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	50
Number of retired or separated participants receiving benefits	2022-01-01	0
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	50
Number of employers contributing to the scheme	2022-01-01	0
2021: EDS SERVICE SOLUTIONS, INC SAN FRANCISCO MEDICAL PLAN 2021 401k membership
Total participants, beginning-of-year	2021-01-01	19
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	33
Number of retired or separated participants receiving benefits	2021-01-01	0
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	33
Number of employers contributing to the scheme	2021-01-01	0
2020: EDS SERVICE SOLUTIONS, INC SAN FRANCISCO MEDICAL PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	109
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	19
Number of retired or separated participants receiving benefits	2020-01-01	0
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	19
Number of employers contributing to the scheme	2020-01-01	0
2019: EDS SERVICE SOLUTIONS, INC SAN FRANCISCO MEDICAL PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	120
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	124
Number of retired or separated participants receiving benefits	2019-01-01	0
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	124
Number of employers contributing to the scheme	2019-01-01	0
2018: EDS SERVICE SOLUTIONS, INC SAN FRANCISCO MEDICAL PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	110
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	94
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	94
Number of employers contributing to the scheme	2018-01-01	0
2017: EDS SERVICE SOLUTIONS, INC SAN FRANCISCO MEDICAL PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	101
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	102
Number of retired or separated participants receiving benefits	2017-01-01	0
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	102

Form 5500 Responses for EDS SERVICE SOLUTIONS, INC SAN FRANCISCO MEDICAL PLAN

2023: EDS SERVICE SOLUTIONS, INC SAN FRANCISCO MEDICAL PLAN 2023 form 5500 responses
2023-01-01	Type of plan entity	Single employer plan
2023-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2023-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2022: EDS SERVICE SOLUTIONS, INC SAN FRANCISCO MEDICAL PLAN 2022 form 5500 responses
2022-01-01	Type of plan entity	Single employer plan
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: EDS SERVICE SOLUTIONS, INC SAN FRANCISCO MEDICAL PLAN 2021 form 5500 responses
2021-01-01	Type of plan entity	Single employer plan
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: EDS SERVICE SOLUTIONS, INC SAN FRANCISCO MEDICAL PLAN 2020 form 5500 responses
2020-01-01	Type of plan entity	Single employer plan
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: EDS SERVICE SOLUTIONS, INC SAN FRANCISCO MEDICAL PLAN 2019 form 5500 responses
2019-01-01	Type of plan entity	Single employer plan
2019-01-01	Plan funding arrangement – Insurance	Yes
2019-01-01	Plan benefit arrangement – Insurance	Yes
2018: EDS SERVICE SOLUTIONS, INC SAN FRANCISCO MEDICAL PLAN 2018 form 5500 responses
2018-01-01	Type of plan entity	Single employer plan
2018-01-01	Plan funding arrangement – Insurance	Yes
2018-01-01	Plan benefit arrangement – Insurance	Yes
2017: EDS SERVICE SOLUTIONS, INC SAN FRANCISCO MEDICAL PLAN 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	First time form 5500 has been submitted	Yes
2017-01-01	Submission has been amended	Yes
2017-01-01	Plan funding arrangement – Insurance	Yes
2017-01-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

CHINESE COMMUNITY HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 00000 )

Policy contract number

S12341/2*K000

Policy instance

Insurance contract or identification number	S12341/2*K000
Number of Individuals Covered	124
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $40,217
Total amount of fees paid to insurance company	USD $0
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $618,726
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $40,217
Amount paid for insurance broker fees	0
Insurance broker organization code?	3

SUTTER HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 15107 )

Policy contract number

197918

Policy instance

Insurance contract or identification number	197918
Number of Individuals Covered	94
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $29,295
Total amount of fees paid to insurance company	USD $0
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $591,398
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $19,363
Amount paid for insurance broker fees	0
Insurance broker organization code?	3

SUTTER HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 15107 )

Policy contract number

197918

Policy instance

Insurance contract or identification number	197918
Number of Individuals Covered	102
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $29,563
Total amount of fees paid to insurance company	USD $0
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $591,261
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $29,563
Amount paid for insurance broker fees	0
Insurance broker organization code?	3
Insurance broker name	HUB INTERNATIONAL

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Company Name:	EDS SERVICE SOLUTIONS, LLC.
Employer identification number (EIN):	471900711
NAIC Classification:	561300