401k Plan data: ALL CHILDREN'S HEALTH SYSTEM LIFE, ACCIDENTAL DEATH AND DISMEMBERMENT PLAN plan

ALL CHILDREN'S HEALTH SYSTEM LIFE, ACCIDENTAL DEATH AND DISMEMBERMENT PLAN 401k Plan overview

Plan Name	ALL CHILDREN'S HEALTH SYSTEM LIFE, ACCIDENTAL DEATH AND DISMEMBERMENT PLAN
Plan identification number	502

ALL CHILDREN'S HEALTH SYSTEM LIFE, ACCIDENTAL DEATH AND DISMEMBERMENT 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

401k Sponsoring company profile

ALL CHILDRENS HEALTH SYSTEM, INC. has sponsored the creation of one or more 401k plans.

Company Name: ALL CHILDRENS HEALTH SYSTEM, INC.

Employer identification number (EIN): 592481740

NAIC Classification: 622000
NAIC Description: Hospitals

Form 5500 Filing Information

Submission information for form 5500 for 401k plan ALL CHILDREN'S HEALTH SYSTEM LIFE, ACCIDENTAL DEATH AND DISMEMBERMENT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
502 2017-01-01 JIM SCHMIDT 2018-09-26 JIM SCHMIDT 2018-09-26
502 2016-01-01 CHRISTOPHER WHITBY CHRISTOPHER WHITBY 2017-10-13
502 2015-01-01 DOUGLAS MYERS DOUGLAS MYERS 2016-10-13
502 2014-01-01 CLAYTON SPRIET CLAYTON SPRIET 2015-10-13
502 2013-01-01 NANCY TEMPLIN NANCY TEMPLIN 2014-10-07
502 2012-01-01 NANCY TEMPLIN NANCY TEMPLIN 2013-10-15
502 2010-10-01 NANCY TEMPLIN NANCY TEMPLIN 2012-07-11
502 2009-10-01 NANCY TEMPLIN NANCY TEMPLIN 2011-07-15
502 2008-10-01

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
502	2017-01-01	JIM SCHMIDT	2018-09-26	JIM SCHMIDT	2018-09-26
502	2016-01-01	CHRISTOPHER WHITBY		CHRISTOPHER WHITBY	2017-10-13
502	2015-01-01	DOUGLAS MYERS		DOUGLAS MYERS	2016-10-13
502	2014-01-01	CLAYTON SPRIET		CLAYTON SPRIET	2015-10-13
502	2013-01-01	NANCY TEMPLIN		NANCY TEMPLIN	2014-10-07
502	2012-01-01	NANCY TEMPLIN		NANCY TEMPLIN	2013-10-15
502	2010-10-01	NANCY TEMPLIN		NANCY TEMPLIN	2012-07-11
502	2009-10-01	NANCY TEMPLIN		NANCY TEMPLIN	2011-07-15
502	2008-10-01

Plan Statistics for ALL CHILDREN'S HEALTH SYSTEM LIFE, ACCIDENTAL DEATH AND DISMEMBERMENT PLAN

401k plan membership statisitcs for ALL CHILDREN'S HEALTH SYSTEM LIFE, ACCIDENTAL DEATH AND DISMEMBERMENT PLAN

Measure Date Value
2017: ALL CHILDREN'S HEALTH SYSTEM LIFE, ACCIDENTAL DEATH AND DISMEMBERMENT PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 4,077
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 4,921
Total of all active and inactive participants 2017-01-01 4,921
Total participants 2017-01-01 4,921
2016: ALL CHILDREN'S HEALTH SYSTEM LIFE, ACCIDENTAL DEATH AND DISMEMBERMENT PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 4,115
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 4,077
Total of all active and inactive participants 2016-01-01 4,077
Total participants 2016-01-01 4,077
2015: ALL CHILDREN'S HEALTH SYSTEM LIFE, ACCIDENTAL DEATH AND DISMEMBERMENT PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 3,952
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 4,115
Total of all active and inactive participants 2015-01-01 4,115
Total participants 2015-01-01 4,115
2014: ALL CHILDREN'S HEALTH SYSTEM LIFE, ACCIDENTAL DEATH AND DISMEMBERMENT PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 3,776
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 3,952
Total of all active and inactive participants 2014-01-01 3,952
Total participants 2014-01-01 3,952
2013: ALL CHILDREN'S HEALTH SYSTEM LIFE, ACCIDENTAL DEATH AND DISMEMBERMENT PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 3,530
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 3,776
Total of all active and inactive participants 2013-01-01 3,776
Total participants 2013-01-01 3,776
2012: ALL CHILDREN'S HEALTH SYSTEM LIFE, ACCIDENTAL DEATH AND DISMEMBERMENT PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 3,102
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 3,530
Total of all active and inactive participants 2012-01-01 3,530
2010: ALL CHILDREN'S HEALTH SYSTEM LIFE, ACCIDENTAL DEATH AND DISMEMBERMENT PLAN 2010 401k membership
Total participants, beginning-of-year 2010-10-01 2,950
Total number of active participants reported on line 7a of the Form 5500 2010-10-01 3,102
Total of all active and inactive participants 2010-10-01 3,102
2009: ALL CHILDREN'S HEALTH SYSTEM LIFE, ACCIDENTAL DEATH AND DISMEMBERMENT PLAN 2009 401k membership
Total participants, beginning-of-year 2009-10-01 1,976
Total number of active participants reported on line 7a of the Form 5500 2009-10-01 2,950
Number of retired or separated participants receiving benefits 2009-10-01 0
Number of other retired or separated participants entitled to future benefits 2009-10-01 0
Total of all active and inactive participants 2009-10-01 2,950

Measure	Date	Value
2017: ALL CHILDREN'S HEALTH SYSTEM LIFE, ACCIDENTAL DEATH AND DISMEMBERMENT PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	4,077
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	4,921
Total of all active and inactive participants	2017-01-01	4,921
Total participants	2017-01-01	4,921
2016: ALL CHILDREN'S HEALTH SYSTEM LIFE, ACCIDENTAL DEATH AND DISMEMBERMENT PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	4,115
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	4,077
Total of all active and inactive participants	2016-01-01	4,077
Total participants	2016-01-01	4,077
2015: ALL CHILDREN'S HEALTH SYSTEM LIFE, ACCIDENTAL DEATH AND DISMEMBERMENT PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	3,952
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	4,115
Total of all active and inactive participants	2015-01-01	4,115
Total participants	2015-01-01	4,115
2014: ALL CHILDREN'S HEALTH SYSTEM LIFE, ACCIDENTAL DEATH AND DISMEMBERMENT PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	3,776
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	3,952
Total of all active and inactive participants	2014-01-01	3,952
Total participants	2014-01-01	3,952
2013: ALL CHILDREN'S HEALTH SYSTEM LIFE, ACCIDENTAL DEATH AND DISMEMBERMENT PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	3,530
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	3,776
Total of all active and inactive participants	2013-01-01	3,776
Total participants	2013-01-01	3,776
2012: ALL CHILDREN'S HEALTH SYSTEM LIFE, ACCIDENTAL DEATH AND DISMEMBERMENT PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	3,102
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	3,530
Total of all active and inactive participants	2012-01-01	3,530
2010: ALL CHILDREN'S HEALTH SYSTEM LIFE, ACCIDENTAL DEATH AND DISMEMBERMENT PLAN 2010 401k membership
Total participants, beginning-of-year	2010-10-01	2,950
Total number of active participants reported on line 7a of the Form 5500	2010-10-01	3,102
Total of all active and inactive participants	2010-10-01	3,102
2009: ALL CHILDREN'S HEALTH SYSTEM LIFE, ACCIDENTAL DEATH AND DISMEMBERMENT PLAN 2009 401k membership
Total participants, beginning-of-year	2009-10-01	1,976
Total number of active participants reported on line 7a of the Form 5500	2009-10-01	2,950
Number of retired or separated participants receiving benefits	2009-10-01	0
Number of other retired or separated participants entitled to future benefits	2009-10-01	0
Total of all active and inactive participants	2009-10-01	2,950

Form 5500 Responses for ALL CHILDREN'S HEALTH SYSTEM LIFE, ACCIDENTAL DEATH AND DISMEMBERMENT PLAN

2017: ALL CHILDREN'S HEALTH SYSTEM LIFE, ACCIDENTAL DEATH AND DISMEMBERMENT PLAN 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	Submission has been amended	No
2017-01-01	This submission is the final filing	No
2017-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2017-01-01	Plan is a collectively bargained plan	No
2017-01-01	Plan funding arrangement – Insurance	Yes
2017-01-01	Plan benefit arrangement – Insurance	Yes
2016: ALL CHILDREN'S HEALTH SYSTEM LIFE, ACCIDENTAL DEATH AND DISMEMBERMENT PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Submission has been amended	No
2016-01-01	This submission is the final filing	No
2016-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-01-01	Plan is a collectively bargained plan	No
2016-01-01	Plan funding arrangement – Insurance	Yes
2016-01-01	Plan benefit arrangement – Insurance	Yes
2015: ALL CHILDREN'S HEALTH SYSTEM LIFE, ACCIDENTAL DEATH AND DISMEMBERMENT PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Submission has been amended	No
2015-01-01	This submission is the final filing	No
2015-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-01-01	Plan is a collectively bargained plan	No
2015-01-01	Plan funding arrangement – Insurance	Yes
2015-01-01	Plan benefit arrangement – Insurance	Yes
2014: ALL CHILDREN'S HEALTH SYSTEM LIFE, ACCIDENTAL DEATH AND DISMEMBERMENT 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 – Insurance	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes
2013: ALL CHILDREN'S HEALTH SYSTEM LIFE, ACCIDENTAL DEATH AND DISMEMBERMENT 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 – Insurance	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2012: ALL CHILDREN'S HEALTH SYSTEM LIFE, ACCIDENTAL DEATH AND DISMEMBERMENT PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Plan funding arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2010: ALL CHILDREN'S HEALTH SYSTEM LIFE, ACCIDENTAL DEATH AND DISMEMBERMENT PLAN 2010 form 5500 responses
2010-10-01	Type of plan entity	Single employer plan
2010-10-01	Plan funding arrangement – Insurance	Yes
2010-10-01	Plan benefit arrangement – Insurance	Yes
2009: ALL CHILDREN'S HEALTH SYSTEM LIFE, ACCIDENTAL DEATH AND DISMEMBERMENT PLAN 2009 form 5500 responses
2009-10-01	Type of plan entity	Single employer plan
2009-10-01	This submission is the final filing	No
2009-10-01	Plan funding arrangement – Insurance	Yes
2009-10-01	Plan benefit arrangement – Insurance	Yes
2008: ALL CHILDREN'S HEALTH SYSTEM LIFE, ACCIDENTAL DEATH AND DISMEMBERMENT PLAN 2008 form 5500 responses
2008-10-01	Type of plan entity	Single employer plan
2008-10-01	Submission has been amended	No
2008-10-01	This submission is the final filing	No
2008-10-01	This return/report is a short plan year return/report (less than 12 months)	No
2008-10-01	Plan is a collectively bargained plan	No

Insurance Providers Used on plan

HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number	395174G
Policy instance	1
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number	395174G
Policy instance	1
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number	395174G
Policy instance	1
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number	395174G
Policy instance	1
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number	395174G
Policy instance	1
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number	395174G
Policy instance	1

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Company Name:	ALL CHILDRENS HEALTH SYSTEM, INC.
Employer identification number (EIN):	592481740
NAIC Classification:	622000
NAIC Description:	Hospitals