401k Plan data: HOSPICE SAVANNAH, INC. LIFE PLAN plan

HOSPICE SAVANNAH, INC. LIFE PLAN 401k Plan overview

Plan Name	HOSPICE SAVANNAH, INC. LIFE PLAN
Plan identification number	501

HOSPICE SAVANNAH, INC. LIFE PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Life insurance Death benefits (include travel accident but not life insurance) Other welfare benefit cover 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.

401k Sponsoring company profile

HOSPICE SAVANNAH, INC. has sponsored the creation of one or more 401k plans.

Company Name: HOSPICE SAVANNAH, INC.

Employer identification number (EIN): 581393820

NAIC Classification: 622000
NAIC Description: Hospitals

Form 5500 Filing Information

Submission information for form 5500 for 401k plan HOSPICE SAVANNAH, INC. LIFE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2018-01-01
501 2017-01-01 CHAD CARNELL 2019-03-27
501 2016-01-01 CHAD CARNELL 2019-03-27
501 2015-01-01 CHAD CARNELL 2019-03-27
501 2014-01-01 RON WILLIAMS RON WILLIAMS 2015-10-21
501 2013-01-01
501 2012-01-01 ART GNANN
501 2011-01-01 ROBIN RUDD
501 2009-01-01 ART GNANN

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
501	2018-01-01
501	2017-01-01	CHAD CARNELL	2019-03-27
501	2016-01-01	CHAD CARNELL	2019-03-27
501	2015-01-01	CHAD CARNELL	2019-03-27
501	2014-01-01	RON WILLIAMS		RON WILLIAMS	2015-10-21
501	2013-01-01
501	2012-01-01	ART GNANN
501	2011-01-01	ROBIN RUDD
501	2009-01-01	ART GNANN

Plan Statistics for HOSPICE SAVANNAH, INC. LIFE PLAN

401k plan membership statisitcs for HOSPICE SAVANNAH, INC. LIFE PLAN

Measure Date Value
2018: HOSPICE SAVANNAH, INC. LIFE PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 124
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 95
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 95
Number of employers contributing to the scheme 2018-01-01 0
2017: HOSPICE SAVANNAH, INC. LIFE PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 121
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 124
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 2017-01-01 124
Number of employers contributing to the scheme 2017-01-01 0
2016: HOSPICE SAVANNAH, INC. LIFE PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 110
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 121
Number of retired or separated participants receiving benefits 2016-01-01 0
Number of other retired or separated participants entitled to future benefits 2016-01-01 0
Total of all active and inactive participants 2016-01-01 121
Number of employers contributing to the scheme 2016-01-01 0
2015: HOSPICE SAVANNAH, INC. LIFE PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 134
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 110
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
Total of all active and inactive participants 2015-01-01 110
Number of employers contributing to the scheme 2015-01-01 0
2014: HOSPICE SAVANNAH, INC. LIFE PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 134
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 134
Total of all active and inactive participants 2014-01-01 134
Total participants 2014-01-01 134
2013: HOSPICE SAVANNAH, INC. LIFE PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 151
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 142
Total of all active and inactive participants 2013-01-01 142
2012: HOSPICE SAVANNAH, INC. LIFE PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 149
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 151
Total of all active and inactive participants 2012-01-01 151
2011: HOSPICE SAVANNAH, INC. LIFE PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 145
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 149
Total of all active and inactive participants 2011-01-01 149
2009: HOSPICE SAVANNAH, INC. LIFE PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 147
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 142
Total of all active and inactive participants 2009-01-01 142

Measure	Date	Value
2018: HOSPICE SAVANNAH, INC. LIFE PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	124
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	95
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	95
Number of employers contributing to the scheme	2018-01-01	0
2017: HOSPICE SAVANNAH, INC. LIFE PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	121
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	124
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	124
Number of employers contributing to the scheme	2017-01-01	0
2016: HOSPICE SAVANNAH, INC. LIFE PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	110
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	121
Number of retired or separated participants receiving benefits	2016-01-01	0
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	121
Number of employers contributing to the scheme	2016-01-01	0
2015: HOSPICE SAVANNAH, INC. LIFE PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	134
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	110
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
Total of all active and inactive participants	2015-01-01	110
Number of employers contributing to the scheme	2015-01-01	0
2014: HOSPICE SAVANNAH, INC. LIFE PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	134
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	134
Total of all active and inactive participants	2014-01-01	134
Total participants	2014-01-01	134
2013: HOSPICE SAVANNAH, INC. LIFE PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	151
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	142
Total of all active and inactive participants	2013-01-01	142
2012: HOSPICE SAVANNAH, INC. LIFE PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	149
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	151
Total of all active and inactive participants	2012-01-01	151
2011: HOSPICE SAVANNAH, INC. LIFE PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	145
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	149
Total of all active and inactive participants	2011-01-01	149
2009: HOSPICE SAVANNAH, INC. LIFE PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	147
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	142
Total of all active and inactive participants	2009-01-01	142

Form 5500 Responses for HOSPICE SAVANNAH, INC. LIFE PLAN

2018: HOSPICE SAVANNAH, INC. LIFE 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: HOSPICE SAVANNAH, INC. LIFE PLAN 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	Plan funding arrangement – Insurance	Yes
2017-01-01	Plan benefit arrangement – Insurance	Yes
2016: HOSPICE SAVANNAH, INC. LIFE PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Plan funding arrangement – Insurance	Yes
2016-01-01	Plan benefit arrangement – Insurance	Yes
2015: HOSPICE SAVANNAH, INC. LIFE PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Plan funding arrangement – Insurance	Yes
2015-01-01	Plan benefit arrangement – Insurance	Yes
2014: HOSPICE SAVANNAH, INC. LIFE 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 – General assets of the sponsor	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes
2013: HOSPICE SAVANNAH, INC. LIFE PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2012: HOSPICE SAVANNAH, INC. LIFE PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2011: HOSPICE SAVANNAH, INC. LIFE PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2009: HOSPICE SAVANNAH, INC. LIFE PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	This submission is the final filing	No
2009-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2009-01-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

GREATER GEORGIA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 97217 )

Policy contract number

GA2108

Policy instance

Insurance contract or identification number	GA2108
Number of Individuals Covered	95
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $851
Total amount of fees paid to insurance company	USD $220
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to Carrier	USD $23,627
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $851
Amount paid for insurance broker fees	220
Additional information about fees paid to insurance broker	FEES
Insurance broker organization code?	3

GREATER GEORGIA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 97217 )

Policy contract number

GA2108

Policy instance

Insurance contract or identification number	GA2108
Number of Individuals Covered	124
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $1,461
Total amount of fees paid to insurance company	USD $619
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to Carrier	USD $20,562
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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Company Name:	HOSPICE SAVANNAH, INC.
Employer identification number (EIN):	581393820
NAIC Classification:	622000
NAIC Description:	Hospitals