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LA HACIENDA EMPLOYEE'S HEALTH BENEFIT PLAN 401k Plan overview

Plan NameLA HACIENDA EMPLOYEE'S HEALTH BENEFIT PLAN
Plan identification number 501

LA HACIENDA EMPLOYEE'S HEALTH BENEFIT PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Other welfare benefit cover

401k Sponsoring company profile

ESPERANZA HEALTH SYSTEMS, LTD DBA LA HACIENDA TREATMENT CENTER has sponsored the creation of one or more 401k plans.

Company Name:ESPERANZA HEALTH SYSTEMS, LTD DBA LA HACIENDA TREATMENT CENTER
Employer identification number (EIN):742664821
NAIC Classification:622000
NAIC Description: Hospitals

Additional information about ESPERANZA HEALTH SYSTEMS, LTD DBA LA HACIENDA TREATMENT CENTER

Jurisdiction of Incorporation: Texas Secretary of State
Incorporation Date: 1993-04-02
Company Identification Number: 0006789510
Legal Registered Office Address: PO BOX 1

HUNT
United States of America (USA)
78024

More information about ESPERANZA HEALTH SYSTEMS, LTD DBA LA HACIENDA TREATMENT CENTER

Form 5500 Filing Information

Submission information for form 5500 for 401k plan LA HACIENDA EMPLOYEE'S HEALTH BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012012-01-01ART VANDIVIER ART VANDIVIER2013-10-01
5012011-01-01ART VANDIVIER ART VANDIVIER2012-10-15
5012009-01-01ART VANDIVIER ART VANDIVIER2010-10-14

Plan Statistics for LA HACIENDA EMPLOYEE'S HEALTH BENEFIT PLAN

401k plan membership statisitcs for LA HACIENDA EMPLOYEE'S HEALTH BENEFIT PLAN

Measure Date Value
2012: LA HACIENDA EMPLOYEE'S HEALTH BENEFIT PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-01172
Total number of active participants reported on line 7a of the Form 55002012-01-01229
Total of all active and inactive participants2012-01-01229
2011: LA HACIENDA EMPLOYEE'S HEALTH BENEFIT PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-01167
Total number of active participants reported on line 7a of the Form 55002011-01-01172
Total of all active and inactive participants2011-01-01172
2009: LA HACIENDA EMPLOYEE'S HEALTH BENEFIT PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-01167
Total number of active participants reported on line 7a of the Form 55002009-01-01162
Number of retired or separated participants receiving benefits2009-01-015
Total of all active and inactive participants2009-01-01167
Number of employers contributing to the scheme2009-01-012

Form 5500 Responses for LA HACIENDA EMPLOYEE'S HEALTH BENEFIT PLAN

2012: LA HACIENDA EMPLOYEE'S HEALTH BENEFIT PLAN 2012 form 5500 responses
2012-01-01Type of plan entityMulti-employer plan
2012-01-01Plan is a collectively bargained planYes
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan funding arrangement – General assets of the sponsorYes
2012-01-01Plan benefit arrangement – InsuranceYes
2012-01-01Plan benefit arrangement – General assets of the sponsorYes
2011: LA HACIENDA EMPLOYEE'S HEALTH BENEFIT PLAN 2011 form 5500 responses
2011-01-01Type of plan entityMulti-employer plan
2011-01-01Plan is a collectively bargained planYes
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan funding arrangement – General assets of the sponsorYes
2011-01-01Plan benefit arrangement – InsuranceYes
2011-01-01Plan benefit arrangement – General assets of the sponsorYes
2009: LA HACIENDA EMPLOYEE'S HEALTH BENEFIT PLAN 2009 form 5500 responses
2009-01-01Type of plan entityMulti-employer plan
2009-01-01This submission is the final filingNo
2009-01-01Plan is a collectively bargained planYes
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan funding arrangement – General assets of the sponsorYes
2009-01-01Plan benefit arrangement – InsuranceYes
2009-01-01Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

INTERFACE EAP (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number
Policy instance 1
Number of Individuals Covered229
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Other welfare benefits providedEAP
Welfare Benefit Premiums Paid to CarrierUSD $6,847
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
QBE A&H (National Association of Insurance Commissioners NAIC id number: 10219 )
Policy contract numberIIS00291-06
Policy instance 2
Insurance contract or identification numberIIS00291-06
Number of Individuals Covered229
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $45,577
Total amount of fees paid to insurance companyUSD $19,523
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $258,551
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $45,577
Amount paid for insurance broker fees19523
Additional information about fees paid to insurance brokerBROKER FEE
Insurance broker organization code?3
Insurance broker nameEBS EMPLOYEE BENEFIT SERVICES, INC.
INTERFACE EAP (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number
Policy instance 1
Number of Individuals Covered172
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Other welfare benefits providedEAP
Welfare Benefit Premiums Paid to CarrierUSD $7,172
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
QBE A&H (National Association of Insurance Commissioners NAIC id number: 10219 )
Policy contract numberIIS00291-06
Policy instance 2
Insurance contract or identification numberIIS00291-06
Number of Individuals Covered172
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $45,288
Total amount of fees paid to insurance companyUSD $20,273
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $250,570
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
INTERFACE EAP (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number
Policy instance 1
Number of Individuals Covered187
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Other welfare benefits providedEAP
Welfare Benefit Premiums Paid to CarrierUSD $6,841
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
QBE A&H (National Association of Insurance Commissioners NAIC id number: 10219 )
Policy contract numberIIS00291-06
Policy instance 2
Insurance contract or identification numberIIS00291-06
Number of Individuals Covered226
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $41,470
Total amount of fees paid to insurance companyUSD $19,181
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $234,995
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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