401k Plan data: STANFORD HEALTH CARE - VALLEYCARE 403(B) PLAN plan

STANFORD HEALTH CARE - VALLEYCARE 403(B) PLAN 401k Plan overview

Plan Name	STANFORD HEALTH CARE - VALLEYCARE 403(B) PLAN
Plan identification number	004

STANFORD HEALTH CARE - VALLEYCARE 403(B) PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

Profit-sharing
ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.

401k Sponsoring company profile

STANFORD HEALTH CARE - VALLEYCARE has sponsored the creation of one or more 401k plans.

Company Name: STANFORD HEALTH CARE - VALLEYCARE

Employer identification number (EIN): 941429628

NAIC Classification: 622000
NAIC Description: Hospitals

Form 5500 Filing Information

Submission information for form 5500 for 401k plan STANFORD HEALTH CARE - VALLEYCARE 403(B) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
004 2023-01-01
004 2022-01-01
004 2021-01-01
004 2020-01-01
004 2019-01-01
004 2018-01-01

Plan Statistics for STANFORD HEALTH CARE - VALLEYCARE 403(B) PLAN

401k plan membership statisitcs for STANFORD HEALTH CARE - VALLEYCARE 403(B) PLAN

Measure Date Value
2023: STANFORD HEALTH CARE - VALLEYCARE 403(B) PLAN 2023 401k membership
Total participants, beginning-of-year 2023-01-01 1,788
Total number of active participants reported on line 7a of the Form 5500 2023-01-01 1,685
Number of retired or separated participants receiving benefits 2023-01-01 4
Number of other retired or separated participants entitled to future benefits 2023-01-01 340
Total of all active and inactive participants 2023-01-01 2,029
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2023-01-01 3
Total participants 2023-01-01 2,032
Number of participants with account balances 2023-01-01 1,770
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2023-01-01 78
2022: STANFORD HEALTH CARE - VALLEYCARE 403(B) PLAN 2022 401k membership
Total participants, beginning-of-year 2022-01-01 1,575
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 1,498
Number of retired or separated participants receiving benefits 2022-01-01 4
Number of other retired or separated participants entitled to future benefits 2022-01-01 285
Total of all active and inactive participants 2022-01-01 1,787
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2022-01-01 1
Total participants 2022-01-01 1,788
Number of participants with account balances 2022-01-01 1,535
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2022-01-01 49
2021: STANFORD HEALTH CARE - VALLEYCARE 403(B) PLAN 2021 401k membership
Total participants, beginning-of-year 2021-01-01 1,452
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 1,324
Number of retired or separated participants receiving benefits 2021-01-01 4
Number of other retired or separated participants entitled to future benefits 2021-01-01 246
Total of all active and inactive participants 2021-01-01 1,574
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2021-01-01 1
Total participants 2021-01-01 1,575
Number of participants with account balances 2021-01-01 1,344
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2021-01-01 53
2020: STANFORD HEALTH CARE - VALLEYCARE 403(B) PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 1,438
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 1,277
Number of retired or separated participants receiving benefits 2020-01-01 2
Number of other retired or separated participants entitled to future benefits 2020-01-01 173
Total of all active and inactive participants 2020-01-01 1,452
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2020-01-01 0
Total participants 2020-01-01 1,452
Number of participants with account balances 2020-01-01 1,264
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-01-01 51
2019: STANFORD HEALTH CARE - VALLEYCARE 403(B) PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 1,381
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 1,344
Number of retired or separated participants receiving benefits 2019-01-01 1
Number of other retired or separated participants entitled to future benefits 2019-01-01 92
Total of all active and inactive participants 2019-01-01 1,437
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-01-01 1
Total participants 2019-01-01 1,438
Number of participants with account balances 2019-01-01 1,206
2018: STANFORD HEALTH CARE - VALLEYCARE 403(B) PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 0
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 1,335
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 46
Total of all active and inactive participants 2018-01-01 1,381
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-01-01 0
Total participants 2018-01-01 1,381
Number of participants with account balances 2018-01-01 1,148
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-01-01 32

Measure	Date	Value
2023: STANFORD HEALTH CARE - VALLEYCARE 403(B) PLAN 2023 401k membership
Total participants, beginning-of-year	2023-01-01	1,788
Total number of active participants reported on line 7a of the Form 5500	2023-01-01	1,685
Number of retired or separated participants receiving benefits	2023-01-01	4
Number of other retired or separated participants entitled to future benefits	2023-01-01	340
Total of all active and inactive participants	2023-01-01	2,029
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2023-01-01	3
Total participants	2023-01-01	2,032
Number of participants with account balances	2023-01-01	1,770
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2023-01-01	78
2022: STANFORD HEALTH CARE - VALLEYCARE 403(B) PLAN 2022 401k membership
Total participants, beginning-of-year	2022-01-01	1,575
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	1,498
Number of retired or separated participants receiving benefits	2022-01-01	4
Number of other retired or separated participants entitled to future benefits	2022-01-01	285
Total of all active and inactive participants	2022-01-01	1,787
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2022-01-01	1
Total participants	2022-01-01	1,788
Number of participants with account balances	2022-01-01	1,535
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2022-01-01	49
2021: STANFORD HEALTH CARE - VALLEYCARE 403(B) PLAN 2021 401k membership
Total participants, beginning-of-year	2021-01-01	1,452
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	1,324
Number of retired or separated participants receiving benefits	2021-01-01	4
Number of other retired or separated participants entitled to future benefits	2021-01-01	246
Total of all active and inactive participants	2021-01-01	1,574
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2021-01-01	1
Total participants	2021-01-01	1,575
Number of participants with account balances	2021-01-01	1,344
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2021-01-01	53
2020: STANFORD HEALTH CARE - VALLEYCARE 403(B) PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	1,438
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	1,277
Number of retired or separated participants receiving benefits	2020-01-01	2
Number of other retired or separated participants entitled to future benefits	2020-01-01	173
Total of all active and inactive participants	2020-01-01	1,452
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-01-01	0
Total participants	2020-01-01	1,452
Number of participants with account balances	2020-01-01	1,264
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-01-01	51
2019: STANFORD HEALTH CARE - VALLEYCARE 403(B) PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	1,381
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	1,344
Number of retired or separated participants receiving benefits	2019-01-01	1
Number of other retired or separated participants entitled to future benefits	2019-01-01	92
Total of all active and inactive participants	2019-01-01	1,437
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-01-01	1
Total participants	2019-01-01	1,438
Number of participants with account balances	2019-01-01	1,206
2018: STANFORD HEALTH CARE - VALLEYCARE 403(B) PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	0
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	1,335
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	46
Total of all active and inactive participants	2018-01-01	1,381
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-01-01	0
Total participants	2018-01-01	1,381
Number of participants with account balances	2018-01-01	1,148
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-01-01	32

Financial Data on STANFORD HEALTH CARE - VALLEYCARE 403(B) PLAN

Measure	Date	Value
2023 : STANFORD HEALTH CARE - VALLEYCARE 403(B) PLAN 2023 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets	2023-12-31	$194
Total unrealized appreciation/depreciation of assets	2023-12-31	$194
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2023-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2023-12-31	$2,735
Total income from all sources (including contributions)	2023-12-31	$39,397,978
Total loss/gain on sale of assets	2023-12-31	$0
Total of all expenses incurred	2023-12-31	$6,595,586
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2023-12-31	$6,475,776
Expenses. Certain deemed distributions of participant loans	2023-12-31	$24,202
Value of total corrective distributions	2023-12-31	$9,280
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2023-12-31	$23,217,662
Value of total assets at end of year	2023-12-31	$116,357,606
Value of total assets at beginning of year	2023-12-31	$83,557,949
Total of administrative expenses incurred including professional, contract, advisory and management fees	2023-12-31	$86,328
Total interest from all sources	2023-12-31	$274,956
Total dividends received (eg from common stock, registered investment company shares)	2023-12-31	$2,274,013
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2023-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2023-12-31	$2,274,013
Was this plan covered by a fidelity bond	2023-12-31	Yes
Value of fidelity bond cover	2023-12-31	$500,000
If this is an individual account plan, was there a blackout period	2023-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2023-12-31	No
Contributions received from participants	2023-12-31	$14,059,896
Participant contributions at end of year	2023-12-31	$2,056,471
Participant contributions at beginning of year	2023-12-31	$1,586,985
Income. Received or receivable in cash from other sources (including rollovers)	2023-12-31	$2,060,344
Value of other receiveables (less allowance for doubtful accounts) at end of year	2023-12-31	$1,958
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2023-12-31	$3
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2023-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2023-12-31	$2,735
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2023-12-31	No
Value of net income/loss	2023-12-31	$32,802,392
Value of net assets at end of year (total assets less liabilities)	2023-12-31	$116,357,606
Value of net assets at beginning of year (total assets less liabilities)	2023-12-31	$83,555,214
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2023-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2023-12-31	No
Were any leases to which the plan was party in default or uncollectible	2023-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2023-12-31	$109,683,560
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2023-12-31	$78,261,529
Interest on participant loans	2023-12-31	$102,722
Interest earned on other investments	2023-12-31	$26,656
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2023-12-31	$3,706,882
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2023-12-31	$2,310,958
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2023-12-31	$2,310,958
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2023-12-31	$145,578
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2023-12-31	$903,242
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2023-12-31	$1,398,474
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2023-12-31	$13,631,153
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2023-12-31	No
Was there a failure to transmit to the plan any participant contributions	2023-12-31	No
Has the plan failed to provide any benefit when due under the plan	2023-12-31	No
Contributions received in cash from employer	2023-12-31	$7,097,422
Employer contributions (assets) at end of year	2023-12-31	$2,377
Employer contributions (assets) at beginning of year	2023-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2023-12-31	$6,475,776
Assets. Corporate common stocks other than exployer securities at end of year	2023-12-31	$3,116
Assets. Corporate common stocks other than exployer securities at beginning of year	2023-12-31	$0
Did the plan have assets held for investment	2023-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2023-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2023-12-31	No
Opinion of an independent qualified public accountant for this plan	2023-12-31	Unqualified
Accountancy firm name	2023-12-31	MOSS ADAMS
Accountancy firm EIN	2023-12-31	910189318
2022 : STANFORD HEALTH CARE - VALLEYCARE 403(B) PLAN 2022 401k financial data
Total unrealized appreciation/depreciation of assets	2022-12-31	$0
Total transfer of assets to this plan	2022-12-31	$123,269
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2022-12-31	$2,735
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2022-12-31	$0
Total income from all sources (including contributions)	2022-12-31	$5,115,855
Total loss/gain on sale of assets	2022-12-31	$0
Total of all expenses incurred	2022-12-31	$8,619,661
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2022-12-31	$8,441,305
Expenses. Certain deemed distributions of participant loans	2022-12-31	$98,301
Value of total corrective distributions	2022-12-31	$34
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2022-12-31	$20,033,815
Value of total assets at end of year	2022-12-31	$83,557,949
Value of total assets at beginning of year	2022-12-31	$86,935,751
Total of administrative expenses incurred including professional, contract, advisory and management fees	2022-12-31	$80,021
Total interest from all sources	2022-12-31	$132,008
Total dividends received (eg from common stock, registered investment company shares)	2022-12-31	$1,828,401
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2022-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2022-12-31	$1,828,401
Was this plan covered by a fidelity bond	2022-12-31	Yes
Value of fidelity bond cover	2022-12-31	$500,000
If this is an individual account plan, was there a blackout period	2022-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2022-12-31	No
Contributions received from participants	2022-12-31	$11,849,724
Participant contributions at end of year	2022-12-31	$1,586,985
Participant contributions at beginning of year	2022-12-31	$1,251,005
Income. Received or receivable in cash from other sources (including rollovers)	2022-12-31	$2,131,054
Value of other receiveables (less allowance for doubtful accounts) at end of year	2022-12-31	$3
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2022-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2022-12-31	$2,735
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2022-12-31	$0
Administrative expenses (other) incurred	2022-12-31	$80,021
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2022-12-31	No
Value of net income/loss	2022-12-31	$-3,503,806
Value of net assets at end of year (total assets less liabilities)	2022-12-31	$83,555,214
Value of net assets at beginning of year (total assets less liabilities)	2022-12-31	$86,935,751
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2022-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2022-12-31	No
Were any leases to which the plan was party in default or uncollectible	2022-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2022-12-31	$78,261,529
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2022-12-31	$83,377,360
Interest on participant loans	2022-12-31	$65,947
Interest earned on other investments	2022-12-31	$30,647
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2022-12-31	$2,310,958
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2022-12-31	$1,249,346
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2022-12-31	$1,249,346
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2022-12-31	$35,414
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2022-12-31	$1,398,474
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2022-12-31	$1,058,040
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2022-12-31	$-16,878,369
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2022-12-31	No
Was there a failure to transmit to the plan any participant contributions	2022-12-31	No
Has the plan failed to provide any benefit when due under the plan	2022-12-31	No
Contributions received in cash from employer	2022-12-31	$6,053,037
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2022-12-31	$8,441,305
Did the plan have assets held for investment	2022-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2022-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2022-12-31	No
Opinion of an independent qualified public accountant for this plan	2022-12-31	Unqualified
Accountancy firm name	2022-12-31	MOSS ADAMS
Accountancy firm EIN	2022-12-31	910189318
2021 : STANFORD HEALTH CARE - VALLEYCARE 403(B) PLAN 2021 401k financial data
Total unrealized appreciation/depreciation of assets	2021-12-31	$0
Total transfer of assets to this plan	2021-12-31	$46,644
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-12-31	$0
Total income from all sources (including contributions)	2021-12-31	$28,461,493
Total loss/gain on sale of assets	2021-12-31	$0
Total of all expenses incurred	2021-12-31	$4,994,445
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2021-12-31	$4,879,376
Expenses. Certain deemed distributions of participant loans	2021-12-31	$27,990
Value of total corrective distributions	2021-12-31	$9,402
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2021-12-31	$18,905,440
Value of total assets at end of year	2021-12-31	$86,935,751
Value of total assets at beginning of year	2021-12-31	$63,422,059
Total of administrative expenses incurred including professional, contract, advisory and management fees	2021-12-31	$77,677
Total interest from all sources	2021-12-31	$82,310
Total dividends received (eg from common stock, registered investment company shares)	2021-12-31	$1,930,743
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2021-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2021-12-31	$1,930,743
Was this plan covered by a fidelity bond	2021-12-31	Yes
Value of fidelity bond cover	2021-12-31	$500,000
If this is an individual account plan, was there a blackout period	2021-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2021-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2021-12-31	No
Contributions received from participants	2021-12-31	$11,095,201
Participant contributions at end of year	2021-12-31	$1,251,005
Participant contributions at beginning of year	2021-12-31	$1,057,766
Income. Received or receivable in cash from other sources (including rollovers)	2021-12-31	$1,695,859
Administrative expenses (other) incurred	2021-12-31	$77,677
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2021-12-31	No
Value of net income/loss	2021-12-31	$23,467,048
Value of net assets at end of year (total assets less liabilities)	2021-12-31	$86,935,751
Value of net assets at beginning of year (total assets less liabilities)	2021-12-31	$63,422,059
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2021-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2021-12-31	No
Were any leases to which the plan was party in default or uncollectible	2021-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2021-12-31	$83,377,360
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2021-12-31	$60,519,812
Interest on participant loans	2021-12-31	$59,133
Interest earned on other investments	2021-12-31	$25,410
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2021-12-31	$1,249,346
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2021-12-31	$1,079,203
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2021-12-31	$1,079,203
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2021-12-31	$-2,233
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2021-12-31	$1,058,040
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2021-12-31	$765,278
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2021-12-31	$7,543,000
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2021-12-31	No
Was there a failure to transmit to the plan any participant contributions	2021-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2021-12-31	No
Contributions received in cash from employer	2021-12-31	$6,114,380
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2021-12-31	$4,879,376
Did the plan have assets held for investment	2021-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2021-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2021-12-31	No
Opinion of an independent qualified public accountant for this plan	2021-12-31	Unqualified
Accountancy firm name	2021-12-31	MOSS ADAMS
Accountancy firm EIN	2021-12-31	910189318
2020 : STANFORD HEALTH CARE - VALLEYCARE 403(B) PLAN 2020 401k financial data
Total unrealized appreciation/depreciation of assets	2020-12-31	$0
Total transfer of assets to this plan	2020-12-31	$1,952,675
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-12-31	$0
Total income from all sources (including contributions)	2020-12-31	$25,298,949
Total loss/gain on sale of assets	2020-12-31	$0
Total of all expenses incurred	2020-12-31	$4,713,046
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2020-12-31	$4,613,827
Expenses. Certain deemed distributions of participant loans	2020-12-31	$20,425
Value of total corrective distributions	2020-12-31	$6,457
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2020-12-31	$16,953,593
Value of total assets at end of year	2020-12-31	$63,422,059
Value of total assets at beginning of year	2020-12-31	$40,883,481
Total of administrative expenses incurred including professional, contract, advisory and management fees	2020-12-31	$72,337
Total interest from all sources	2020-12-31	$71,489
Total dividends received (eg from common stock, registered investment company shares)	2020-12-31	$1,291,950
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2020-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2020-12-31	$1,291,950
Was this plan covered by a fidelity bond	2020-12-31	Yes
Value of fidelity bond cover	2020-12-31	$500,000
If this is an individual account plan, was there a blackout period	2020-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2020-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2020-12-31	No
Contributions received from participants	2020-12-31	$9,324,776
Participant contributions at end of year	2020-12-31	$1,057,766
Participant contributions at beginning of year	2020-12-31	$822,288
Income. Received or receivable in cash from other sources (including rollovers)	2020-12-31	$1,900,291
Administrative expenses (other) incurred	2020-12-31	$72,337
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2020-12-31	No
Value of net income/loss	2020-12-31	$20,585,903
Value of net assets at end of year (total assets less liabilities)	2020-12-31	$63,422,059
Value of net assets at beginning of year (total assets less liabilities)	2020-12-31	$40,883,481
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2020-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2020-12-31	No
Were any leases to which the plan was party in default or uncollectible	2020-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2020-12-31	$60,519,812
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2020-12-31	$39,453,050
Interest on participant loans	2020-12-31	$54,129
Interest earned on other investments	2020-12-31	$15,371
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2020-12-31	$1,079,203
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2020-12-31	$359,230
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2020-12-31	$359,230
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2020-12-31	$1,989
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2020-12-31	$765,278
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2020-12-31	$248,913
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2020-12-31	$6,981,917
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2020-12-31	No
Was there a failure to transmit to the plan any participant contributions	2020-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2020-12-31	No
Contributions received in cash from employer	2020-12-31	$5,728,526
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2020-12-31	$4,613,827
Did the plan have assets held for investment	2020-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2020-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2020-12-31	No
Opinion of an independent qualified public accountant for this plan	2020-12-31	Unqualified
Accountancy firm name	2020-12-31	MOSS ADAMS
Accountancy firm EIN	2020-12-31	910189318
2019 : STANFORD HEALTH CARE - VALLEYCARE 403(B) PLAN 2019 401k financial data
Total unrealized appreciation/depreciation of assets	2019-12-31	$0
Total transfer of assets to this plan	2019-12-31	$1,270,106
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$0
Total income from all sources (including contributions)	2019-12-31	$21,513,584
Total loss/gain on sale of assets	2019-12-31	$0
Total of all expenses incurred	2019-12-31	$3,070,260
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$2,990,506
Expenses. Certain deemed distributions of participant loans	2019-12-31	$4,729
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$15,577,860
Value of total assets at end of year	2019-12-31	$40,883,481
Value of total assets at beginning of year	2019-12-31	$21,170,051
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$75,025
Total interest from all sources	2019-12-31	$49,792
Total dividends received (eg from common stock, registered investment company shares)	2019-12-31	$4,704,209
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2019-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2019-12-31	$4,704,209
Was this plan covered by a fidelity bond	2019-12-31	Yes
Value of fidelity bond cover	2019-12-31	$500,000
If this is an individual account plan, was there a blackout period	2019-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2019-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2019-12-31	No
Contributions received from participants	2019-12-31	$8,897,129
Participant contributions at end of year	2019-12-31	$822,288
Participant contributions at beginning of year	2019-12-31	$478,845
Income. Received or receivable in cash from other sources (including rollovers)	2019-12-31	$863,633
Administrative expenses (other) incurred	2019-12-31	$75,025
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-12-31	No
Value of net income/loss	2019-12-31	$18,443,324
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$40,883,481
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$21,170,051
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2019-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2019-12-31	No
Were any leases to which the plan was party in default or uncollectible	2019-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2019-12-31	$39,453,050
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2019-12-31	$20,227,769
Interest on participant loans	2019-12-31	$36,675
Interest earned on other investments	2019-12-31	$6,853
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2019-12-31	$359,230
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2019-12-31	$292,869
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2019-12-31	$292,869
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2019-12-31	$6,264
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2019-12-31	$248,913
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2019-12-31	$170,568
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2019-12-31	$1,181,723
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2019-12-31	No
Was there a failure to transmit to the plan any participant contributions	2019-12-31	No
Has the plan failed to provide any benefit when due under the plan	2019-12-31	No
Contributions received in cash from employer	2019-12-31	$5,817,098
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-31	$2,990,506
Did the plan have assets held for investment	2019-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2019-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2019-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2019-12-31	Disclaimer
Accountancy firm name	2019-12-31	MOSS ADAMS
Accountancy firm EIN	2019-12-31	910189318
2018 : STANFORD HEALTH CARE - VALLEYCARE 403(B) PLAN 2018 401k financial data
Total unrealized appreciation/depreciation of assets	2018-12-31	$0
Total transfer of assets to this plan	2018-12-31	$8,135,078
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-12-31	$0
Total income from all sources (including contributions)	2018-12-31	$13,316,247
Total loss/gain on sale of assets	2018-12-31	$0
Total of all expenses incurred	2018-12-31	$281,274
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2018-12-31	$223,474
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2018-12-31	$14,889,405
Value of total assets at end of year	2018-12-31	$21,170,051
Value of total assets at beginning of year	2018-12-31	$0
Total of administrative expenses incurred including professional, contract, advisory and management fees	2018-12-31	$57,800
Total interest from all sources	2018-12-31	$13,821
Total dividends received (eg from common stock, registered investment company shares)	2018-12-31	$553,538
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2018-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2018-12-31	$553,538
Was this plan covered by a fidelity bond	2018-12-31	Yes
Value of fidelity bond cover	2018-12-31	$500,000
If this is an individual account plan, was there a blackout period	2018-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2018-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2018-12-31	No
Contributions received from participants	2018-12-31	$8,175,306
Participant contributions at end of year	2018-12-31	$478,845
Participant contributions at beginning of year	2018-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2018-12-31	$749,684
Administrative expenses (other) incurred	2018-12-31	$57,800
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2018-12-31	No
Value of net income/loss	2018-12-31	$13,034,973
Value of net assets at end of year (total assets less liabilities)	2018-12-31	$21,170,051
Value of net assets at beginning of year (total assets less liabilities)	2018-12-31	$0
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2018-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2018-12-31	No
Were any leases to which the plan was party in default or uncollectible	2018-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2018-12-31	$20,227,769
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2018-12-31	$0
Interest on participant loans	2018-12-31	$7,632
Interest earned on other investments	2018-12-31	$2,601
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2018-12-31	$292,869
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2018-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2018-12-31	$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2018-12-31	$3,588
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2018-12-31	$170,568
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2018-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2018-12-31	$-2,140,517
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2018-12-31	No
Was there a failure to transmit to the plan any participant contributions	2018-12-31	No
Has the plan failed to provide any benefit when due under the plan	2018-12-31	No
Contributions received in cash from employer	2018-12-31	$5,964,415
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2018-12-31	$223,474
Did the plan have assets held for investment	2018-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2018-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2018-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2018-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2018-12-31	Disclaimer
Accountancy firm name	2018-12-31	MOSS ADAMS
Accountancy firm EIN	2018-12-31	910189318

Form 5500 Responses for STANFORD HEALTH CARE - VALLEYCARE 403(B) PLAN

2023: STANFORD HEALTH CARE - VALLEYCARE 403(B) PLAN 2023 form 5500 responses
2023-01-01	Type of plan entity	Single employer plan
2023-01-01	Submission has been amended	No
2023-01-01	This submission is the final filing	No
2023-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2023-01-01	Plan is a collectively bargained plan	No
2023-01-01	Plan funding arrangement – Insurance	Yes
2023-01-01	Plan funding arrangement – Trust	Yes
2023-01-01	Plan benefit arrangement – Insurance	Yes
2023-01-01	Plan benefit arrangement - Trust	Yes
2022: STANFORD HEALTH CARE - VALLEYCARE 403(B) PLAN 2022 form 5500 responses
2022-01-01	Type of plan entity	Single employer plan
2022-01-01	Submission has been amended	No
2022-01-01	This submission is the final filing	No
2022-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2022-01-01	Plan is a collectively bargained plan	No
2022-01-01	Plan funding arrangement – Insurance	Yes
2022-01-01	Plan funding arrangement – Trust	Yes
2022-01-01	Plan benefit arrangement – Insurance	Yes
2022-01-01	Plan benefit arrangement - Trust	Yes
2021: STANFORD HEALTH CARE - VALLEYCARE 403(B) PLAN 2021 form 5500 responses
2021-01-01	Type of plan entity	Single employer plan
2021-01-01	Submission has been amended	No
2021-01-01	This submission is the final filing	No
2021-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2021-01-01	Plan is a collectively bargained plan	No
2021-01-01	Plan funding arrangement – Insurance	Yes
2021-01-01	Plan funding arrangement – Trust	Yes
2021-01-01	Plan benefit arrangement – Insurance	Yes
2021-01-01	Plan benefit arrangement - Trust	Yes
2020: STANFORD HEALTH CARE - VALLEYCARE 403(B) PLAN 2020 form 5500 responses
2020-01-01	Type of plan entity	Single employer plan
2020-01-01	Submission has been amended	No
2020-01-01	This submission is the final filing	No
2020-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2020-01-01	Plan is a collectively bargained plan	No
2020-01-01	Plan funding arrangement – Insurance	Yes
2020-01-01	Plan funding arrangement – Trust	Yes
2020-01-01	Plan benefit arrangement – Insurance	Yes
2020-01-01	Plan benefit arrangement - Trust	Yes
2019: STANFORD HEALTH CARE - VALLEYCARE 403(B) PLAN 2019 form 5500 responses
2019-01-01	Type of plan entity	Single employer plan
2019-01-01	Submission has been amended	No
2019-01-01	This submission is the final filing	No
2019-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2019-01-01	Plan is a collectively bargained plan	No
2019-01-01	Plan funding arrangement – Insurance	Yes
2019-01-01	Plan funding arrangement – Trust	Yes
2019-01-01	Plan benefit arrangement – Insurance	Yes
2019-01-01	Plan benefit arrangement - Trust	Yes
2018: STANFORD HEALTH CARE - VALLEYCARE 403(B) PLAN 2018 form 5500 responses
2018-01-01	Type of plan entity	Single employer plan
2018-01-01	First time form 5500 has been submitted	Yes
2018-01-01	Submission has been amended	No
2018-01-01	This submission is the final filing	No
2018-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2018-01-01	Plan is a collectively bargained plan	No
2018-01-01	Plan funding arrangement – Insurance	Yes
2018-01-01	Plan funding arrangement – Trust	Yes
2018-01-01	Plan benefit arrangement – Insurance	Yes
2018-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

NEW YORK LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66915 )

Policy contract number

GA80238

Policy instance

Insurance contract or identification number	GA80238
Number of Individuals Covered	19
Insurance policy start date	2023-01-08
Insurance policy end date	2023-12-31
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	Yes
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

NEW YORK LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66915 )

Policy contract number

GA80238

Policy instance

Insurance contract or identification number	GA80238
Number of Individuals Covered	21
Insurance policy start date	2022-01-08
Insurance policy end date	2022-12-31
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	Yes
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

NEW YORK LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66915 )

Policy contract number

GA80238

Policy instance

Insurance contract or identification number	GA80238
Number of Individuals Covered	17
Insurance policy start date	2021-01-08
Insurance policy end date	2021-12-31
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	Yes
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

NEW YORK LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66915 )

Policy contract number

GA80238

Policy instance

Insurance contract or identification number	GA80238
Number of Individuals Covered	19
Insurance policy start date	2020-01-08
Insurance policy end date	2020-12-31
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	Yes
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

NEW YORK LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66915 )

Policy contract number

GA80238

Policy instance

Insurance contract or identification number	GA80238
Number of Individuals Covered	18
Insurance policy start date	2019-01-08
Insurance policy end date	2019-12-31
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	Yes
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

NEW YORK LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66915 )

Policy contract number

GA80238

Policy instance

Insurance contract or identification number	GA80238
Number of Individuals Covered	16
Insurance policy start date	2018-01-08
Insurance policy end date	2018-12-31
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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Company Name:	STANFORD HEALTH CARE - VALLEYCARE
Employer identification number (EIN):	941429628
NAIC Classification:	622000
NAIC Description:	Hospitals