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| Plan Name | EVERGREEN HEALTH SERVICES LIFE & DISABILITY PLAN |
| Plan identification number | 504 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | EHS INC |
| Employer identification number (EIN): | 161202971 |
| NAIC Classification: | 621498 |
| NAIC Description: | All Other Outpatient Care Centers |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 504 | 2015-01-01 | ||||
| 504 | 2014-01-01 |
| Measure | Date | Value |
|---|---|---|
| 2015: EVERGREEN HEALTH SERVICES LIFE & DISABILITY PLAN 2015 401k membership | ||
| Total participants, beginning-of-year | 2015-01-01 | 183 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-01-01 | 221 |
| Total of all active and inactive participants | 2015-01-01 | 221 |
| 2014: EVERGREEN HEALTH SERVICES LIFE & DISABILITY PLAN 2014 401k membership | ||
| Total participants, beginning-of-year | 2014-01-01 | 141 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-01-01 | 183 |
| Total of all active and inactive participants | 2014-01-01 | 183 |
| 2015: EVERGREEN HEALTH SERVICES LIFE & DISABILITY PLAN 2015 form 5500 responses | ||
|---|---|---|
| 2015-01-01 | Type of plan entity | Single employer plan |
| 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: EVERGREEN HEALTH SERVICES LIFE & DISABILITY PLAN 2014 form 5500 responses | ||
| 2014-01-01 | Type of plan entity | Single employer plan |
| 2014-01-01 | First time form 5500 has been submitted | Yes |
| 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 |
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