401k Plan data: YOSEMITE PATHOLOGY HOLDINGS, LLC EMPLOYEE WELFARE PLAN plan

YOSEMITE PATHOLOGY HOLDINGS, LLC EMPLOYEE WELFARE PLAN 401k Plan overview

Plan Name	YOSEMITE PATHOLOGY HOLDINGS, LLC EMPLOYEE WELFARE PLAN
Plan identification number	501

YOSEMITE PATHOLOGY HOLDINGS, LLC EMPLOYEE WELFARE PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) Life insurance Dental Vision Death benefits (include travel accident but not life insurance)

401k Sponsoring company profile

YOSEMITE PATHOLOGY HOLDINGS, LLC has sponsored the creation of one or more 401k plans.

Company Name: YOSEMITE PATHOLOGY HOLDINGS, LLC

Employer identification number (EIN): 820655649

NAIC Classification: 621399
NAIC Description: Offices of All Other Miscellaneous Health Practitioners

Form 5500 Filing Information

Submission information for form 5500 for 401k plan YOSEMITE PATHOLOGY HOLDINGS, LLC EMPLOYEE WELFARE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2022-01-01 JENNIFER PINASCO 2023-07-27
501 2021-01-01 JENNIFER PINASCO 2023-07-27

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
501	2022-01-01	JENNIFER PINASCO	2023-07-27
501	2021-01-01	JENNIFER PINASCO	2023-07-27

Form 5500 Responses for YOSEMITE PATHOLOGY HOLDINGS, LLC EMPLOYEE WELFARE PLAN

2022: YOSEMITE PATHOLOGY HOLDINGS, LLC EMPLOYEE WELFARE PLAN 2022 form 5500 responses
2022-01-01	Type of plan entity	Single employer plan
2022-01-01	Plan funding arrangement – Insurance	Yes
2022-01-01	Plan benefit arrangement – Insurance	Yes
2021: YOSEMITE PATHOLOGY HOLDINGS, LLC EMPLOYEE WELFARE PLAN 2021 form 5500 responses
2021-01-01	Type of plan entity	Single employer plan
2021-01-01	Plan funding arrangement – Insurance	Yes
2021-01-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 )

Policy contract number

712928

Policy instance

Insurance contract or identification number	712928
Number of Individuals Covered	69
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $28,464
Total amount of fees paid to insurance company	USD $264
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $467,063
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

PRINCIPAL LIFE INSURANCE (National Association of Insurance Commissioners NAIC id number: 61271 )

Policy contract number

1104696

Policy instance

Insurance contract or identification number	1104696
Number of Individuals Covered	239
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $9,041
Total amount of fees paid to insurance company	USD $4,798
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to Carrier	USD $116,196
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )

Policy contract number

923266

Policy instance

Insurance contract or identification number	923266
Number of Individuals Covered	111
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $36,357
Total amount of fees paid to insurance company	USD $1,440
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $727,130
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 )

Policy contract number

712928

Policy instance

UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )

Policy contract number

923266

Policy instance

PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )

Policy contract number

1104696

Policy instance

Potentially related plans

YOSEMITE PATHOLOGY MEDICAL GRP 401(K) [EIN = 942547501]

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Company Name:	YOSEMITE PATHOLOGY HOLDINGS, LLC
Employer identification number (EIN):	820655649
NAIC Classification:	621399
NAIC Description:	Offices of All Other Miscellaneous Health Practitioners