401k Plan data: AMERICAN HOMEPATIENT, INC. HEALTH AND WELFARE plan

AMERICAN HOMEPATIENT, INC. HEALTH AND WELFARE 401k Plan overview

Plan Name	AMERICAN HOMEPATIENT, INC. HEALTH AND WELFARE
Plan identification number	506

AMERICAN HOMEPATIENT, INC. HEALTH AND WELFARE Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) Life insurance Dental Vision Temporary disability (accident and sickness) Long-term disability cover Death benefits (include travel accident but not life insurance)

401k Sponsoring company profile

AMERICAN HOMEPATIENT, INC. has sponsored the creation of one or more 401k plans.

Company Name: AMERICAN HOMEPATIENT, INC.

Employer identification number (EIN): 621474680

NAIC Classification: 623000
NAIC Description: Nursing and Residential Care Facilities

Additional information about AMERICAN HOMEPATIENT, INC.

Jurisdiction of Incorporation: Nevada Department of State

Incorporation Date: 2010-04-27

Company Identification Number: 20101307603

Legal Registered Office Address: 701 S CARSON ST STE 200

CARSON CITY
United States of America (USA)
89701

More information about AMERICAN HOMEPATIENT, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan AMERICAN HOMEPATIENT, INC. HEALTH AND WELFARE

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
506 2016-01-01
506 2015-01-01 SANDY IRVIN SANDY IRVIN 2016-09-26
506 2014-01-01 SANDY IRVIN SANDY IRVIN 2015-10-12
506 2013-01-01 SANDY IRVIN SANDY IRVIN 2014-10-09
506 2012-01-01 SANDY IRVIN
506 2011-01-01 SANDY IRVIN
506 2010-01-01 SANDY IRVIN SANDY IRVIN 2011-10-12
506 2009-01-01 SANDY IRVIN
506 2009-01-01 SANDY IRVIN

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
506	2016-01-01
506	2015-01-01	SANDY IRVIN	SANDY IRVIN	2016-09-26
506	2014-01-01	SANDY IRVIN	SANDY IRVIN	2015-10-12
506	2013-01-01	SANDY IRVIN	SANDY IRVIN	2014-10-09
506	2012-01-01	SANDY IRVIN
506	2011-01-01	SANDY IRVIN
506	2010-01-01	SANDY IRVIN	SANDY IRVIN	2011-10-12
506	2009-01-01	SANDY IRVIN
506	2009-01-01	SANDY IRVIN

Plan Statistics for AMERICAN HOMEPATIENT, INC. HEALTH AND WELFARE

401k plan membership statisitcs for AMERICAN HOMEPATIENT, INC. HEALTH AND WELFARE

Measure Date Value
2016: AMERICAN HOMEPATIENT, INC. HEALTH AND WELFARE 2016 401k membership
Total participants, beginning-of-year 2016-01-01 2,238
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 0
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 0
2015: AMERICAN HOMEPATIENT, INC. HEALTH AND WELFARE 2015 401k membership
Total participants, beginning-of-year 2015-01-01 2,192
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 2,238
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 2,238
2014: AMERICAN HOMEPATIENT, INC. HEALTH AND WELFARE 2014 401k membership
Total participants, beginning-of-year 2014-01-01 2,255
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 2,192
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 2,192
2013: AMERICAN HOMEPATIENT, INC. HEALTH AND WELFARE 2013 401k membership
Total participants, beginning-of-year 2013-01-01 2,095
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 2,176
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 2,176
2012: AMERICAN HOMEPATIENT, INC. HEALTH AND WELFARE 2012 401k membership
Total participants, beginning-of-year 2012-01-01 2,140
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 2,007
Number of retired or separated participants receiving benefits 2012-01-01 21
Number of other retired or separated participants entitled to future benefits 2012-01-01 67
Total of all active and inactive participants 2012-01-01 2,095
2011: AMERICAN HOMEPATIENT, INC. HEALTH AND WELFARE 2011 401k membership
Total participants, beginning-of-year 2011-01-01 2,374
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 2,140
Number of retired or separated participants receiving benefits 2011-01-01 38
Number of other retired or separated participants entitled to future benefits 2011-01-01 60
Total of all active and inactive participants 2011-01-01 2,238
2010: AMERICAN HOMEPATIENT, INC. HEALTH AND WELFARE 2010 401k membership
Total participants, beginning-of-year 2010-01-01 2,126
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 2,279
Number of retired or separated participants receiving benefits 2010-01-01 44
Number of other retired or separated participants entitled to future benefits 2010-01-01 51
Total of all active and inactive participants 2010-01-01 2,374
2009: AMERICAN HOMEPATIENT, INC. HEALTH AND WELFARE 2009 401k membership
Total participants, beginning-of-year 2009-01-01 2,272
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 2,084
Number of retired or separated participants receiving benefits 2009-01-01 42
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 2,126
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 2,126
Number of participants with account balances 2009-01-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 0

Measure	Date	Value
2016: AMERICAN HOMEPATIENT, INC. HEALTH AND WELFARE 2016 401k membership
Total participants, beginning-of-year	2016-01-01	2,238
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	0
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	0
2015: AMERICAN HOMEPATIENT, INC. HEALTH AND WELFARE 2015 401k membership
Total participants, beginning-of-year	2015-01-01	2,192
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	2,238
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	2,238
2014: AMERICAN HOMEPATIENT, INC. HEALTH AND WELFARE 2014 401k membership
Total participants, beginning-of-year	2014-01-01	2,255
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	2,192
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	2,192
2013: AMERICAN HOMEPATIENT, INC. HEALTH AND WELFARE 2013 401k membership
Total participants, beginning-of-year	2013-01-01	2,095
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	2,176
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	2,176
2012: AMERICAN HOMEPATIENT, INC. HEALTH AND WELFARE 2012 401k membership
Total participants, beginning-of-year	2012-01-01	2,140
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	2,007
Number of retired or separated participants receiving benefits	2012-01-01	21
Number of other retired or separated participants entitled to future benefits	2012-01-01	67
Total of all active and inactive participants	2012-01-01	2,095
2011: AMERICAN HOMEPATIENT, INC. HEALTH AND WELFARE 2011 401k membership
Total participants, beginning-of-year	2011-01-01	2,374
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	2,140
Number of retired or separated participants receiving benefits	2011-01-01	38
Number of other retired or separated participants entitled to future benefits	2011-01-01	60
Total of all active and inactive participants	2011-01-01	2,238
2010: AMERICAN HOMEPATIENT, INC. HEALTH AND WELFARE 2010 401k membership
Total participants, beginning-of-year	2010-01-01	2,126
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	2,279
Number of retired or separated participants receiving benefits	2010-01-01	44
Number of other retired or separated participants entitled to future benefits	2010-01-01	51
Total of all active and inactive participants	2010-01-01	2,374
2009: AMERICAN HOMEPATIENT, INC. HEALTH AND WELFARE 2009 401k membership
Total participants, beginning-of-year	2009-01-01	2,272
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	2,084
Number of retired or separated participants receiving benefits	2009-01-01	42
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	2,126
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	2,126
Number of participants with account balances	2009-01-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	0

Form 5500 Responses for AMERICAN HOMEPATIENT, INC. HEALTH AND WELFARE

2016: AMERICAN HOMEPATIENT, INC. HEALTH AND WELFARE 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	Yes
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 funding arrangement – General assets of the sponsor	Yes
2016-01-01	Plan benefit arrangement – Insurance	Yes
2016-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2015: AMERICAN HOMEPATIENT, INC. HEALTH AND WELFARE 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 funding arrangement – General assets of the sponsor	Yes
2015-01-01	Plan benefit arrangement – Insurance	Yes
2015-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2014: AMERICAN HOMEPATIENT, INC. HEALTH AND WELFARE 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 funding arrangement – General assets of the sponsor	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes
2014-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2013: AMERICAN HOMEPATIENT, INC. HEALTH AND WELFARE 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 funding arrangement – General assets of the sponsor	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2013-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2012: AMERICAN HOMEPATIENT, INC. HEALTH AND WELFARE 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 – Insurance	Yes
2012-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2011: AMERICAN HOMEPATIENT, INC. HEALTH AND WELFARE 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 – Insurance	Yes
2011-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2011-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2010: AMERICAN HOMEPATIENT, INC. HEALTH AND WELFARE 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 – Insurance	Yes
2010-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2010-01-01	Plan benefit arrangement – Insurance	Yes
2010-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2009: AMERICAN HOMEPATIENT, INC. HEALTH AND WELFARE 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	Submission has been amended	Yes
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 – Insurance	Yes
2009-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2009-01-01	Plan benefit arrangement – Insurance	Yes
2009-01-01	Plan benefit arrangement – General assets of the sponsor	Yes

Insurance Providers Used on plan

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number	10183179
Policy instance	2
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number	12299330
Policy instance	1
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number	12299330
Policy instance	1
GEISINGER QUALITY OPTIONS, INC (National Association of Insurance Commissioners NAIC id number: 95923 )
Policy contract number	100172
Policy instance	2
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number	10183179
Policy instance	3
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number	12299330
Policy instance	1
GEISINGER QUALITY OPTIONS, INC (National Association of Insurance Commissioners NAIC id number: 95923 )
Policy contract number	100172
Policy instance	2
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number	94810
Policy instance	3
GEISINGER QUALITY OPTIONS, INC (National Association of Insurance Commissioners NAIC id number: 95923 )
Policy contract number	100172
Policy instance	1
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number	94810 / 94812
Policy instance	3
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number	12299330
Policy instance	2
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number	94810 / 94812
Policy instance	2
GEISINGER QUALITY OPTIONS, INC (National Association of Insurance Commissioners NAIC id number: 95923 )
Policy contract number	100172
Policy instance	1
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number	12299330
Policy instance	3
HEALTHNOW NEW YORK, INC. DBA BLUESHIELD OF NORTHEASTERN NEW YORK (National Association of Insurance Commissioners NAIC id number: 55204 )
Policy contract number	00403236
Policy instance	4
GEISINGER QUALITY OPTIONS, INC (National Association of Insurance Commissioners NAIC id number: 95923 )
Policy contract number	100172
Policy instance	3
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number	090124
Policy instance	6
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number	12299330
Policy instance	7
DELTA DENTAL OF TENNESSEE (National Association of Insurance Commissioners NAIC id number: 54526 )
Policy contract number	2676
Policy instance	2
CAPITAL HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 95112 )
Policy contract number	00140
Policy instance	1
MVP HEALTH CARE (National Association of Insurance Commissioners NAIC id number: 95521 )
Policy contract number	X0181
Policy instance	5

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Company Name:	AMERICAN HOMEPATIENT, INC.
Employer identification number (EIN):	621474680
NAIC Classification:	623000
NAIC Description:	Nursing and Residential Care Facilities

Jurisdiction of Incorporation:	Nevada Department of State
Incorporation Date:	2010-04-27
Company Identification Number:	20101307603
Legal Registered Office Address:	701 S CARSON ST STE 200 CARSON CITY United States of America (USA) 89701