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| Plan Name | SCOTT & WHITE HEALTHCARE EMPLOYEE WELFARE BENEFITS PLAN |
| Plan identification number | 502 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
|
| Company Name: | SCOTT & WHITE HEALTHCARE |
| Employer identification number (EIN): | 264532547 |
| NAIC Classification: | 622000 |
| NAIC Description: | Hospitals |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 502 | 2015-01-01 | JOHN LACY | JOHN LACY | 2016-10-03 | |
| 502 | 2014-01-01 | DONNA WALLACE-STRUNG | DONNA WALLACE-STRUNG | 2016-07-29 | |
| 502 | 2013-01-01 | DONNA WALLACE-STRUNG | DONNA WALLACE-STRUNG | 2016-07-29 | |
| 502 | 2012-01-01 | MARK HALLEE |
| Measure | Date | Value |
|---|---|---|
| 2015: SCOTT & WHITE HEALTHCARE EMPLOYEE WELFARE BENEFITS PLAN 2015 401k membership | ||
| Total participants, beginning-of-year | 2015-01-01 | 14,288 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-01-01 | 0 |
| Total of all active and inactive participants | 2015-01-01 | 0 |
| 2014: SCOTT & WHITE HEALTHCARE EMPLOYEE WELFARE BENEFITS PLAN 2014 401k membership | ||
| Total participants, beginning-of-year | 2014-01-01 | 13,943 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-01-01 | 14,288 |
| Total of all active and inactive participants | 2014-01-01 | 14,288 |
| 2013: SCOTT & WHITE HEALTHCARE EMPLOYEE WELFARE BENEFITS PLAN 2013 401k membership | ||
| Total participants, beginning-of-year | 2013-01-01 | 11,346 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-01-01 | 13,943 |
| Total of all active and inactive participants | 2013-01-01 | 13,943 |
| 2012: SCOTT & WHITE HEALTHCARE EMPLOYEE WELFARE BENEFITS PLAN 2012 401k membership | ||
| Total participants, beginning-of-year | 2012-01-01 | 9,605 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-01-01 | 11,346 |
| Total of all active and inactive participants | 2012-01-01 | 11,346 |
| Measure | Date | Value |
|---|---|---|
| 2013 : SCOTT & WHITE HEALTHCARE EMPLOYEE WELFARE BENEFITS PLAN 2013 401k financial data | ||
| Total of all expenses incurred | 2013-12-31 | $28,166 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2013-12-31 | $28,166 |
| Value of total assets at beginning of year | 2013-12-31 | $28,166 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2013-12-31 | Yes |
| Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan | 2013-12-31 | $0 |
| Was this plan covered by a fidelity bond | 2013-12-31 | No |
| If this is an individual account plan, was there a blackout period | 2013-12-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2013-12-31 | No |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2013-12-31 | No |
| Value of net income/loss | 2013-12-31 | $-28,166 |
| Value of net assets at beginning of year (total assets less liabilities) | 2013-12-31 | $28,166 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2013-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2013-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2013-12-31 | No |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2013-12-31 | $28,166 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2013-12-31 | $28,166 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2013-12-31 | No |
| Was there a failure to transmit to the plan any participant contributions | 2013-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2013-12-31 | No |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2013-12-31 | $28,166 |
| Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2013-12-31 | No |
| Did the plan have assets held for investment | 2013-12-31 | No |
| 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 | 2013-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2013-12-31 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2013-12-31 | Yes |
| Opinion of an independent qualified public accountant for this plan | 2013-12-31 | Disclaimer |
| Accountancy firm name | 2013-12-31 | BKD, LLP |
| Accountancy firm EIN | 2013-12-31 | 440160260 |
| 2012 : SCOTT & WHITE HEALTHCARE EMPLOYEE WELFARE BENEFITS PLAN 2012 401k financial data | ||
| Total income from all sources (including contributions) | 2012-12-31 | $970,005 |
| Total of all expenses incurred | 2012-12-31 | $1,019,424 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2012-12-31 | $1,019,424 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2012-12-31 | $969,948 |
| Value of total assets at end of year | 2012-12-31 | $28,166 |
| Value of total assets at beginning of year | 2012-12-31 | $77,585 |
| Total interest from all sources | 2012-12-31 | $57 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2012-12-31 | No |
| Was this plan covered by a fidelity bond | 2012-12-31 | No |
| If this is an individual account plan, was there a blackout period | 2012-12-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2012-12-31 | No |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2012-12-31 | No |
| Value of net income/loss | 2012-12-31 | $-49,419 |
| Value of net assets at end of year (total assets less liabilities) | 2012-12-31 | $28,166 |
| Value of net assets at beginning of year (total assets less liabilities) | 2012-12-31 | $77,585 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2012-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2012-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2012-12-31 | No |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2012-12-31 | $28,166 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2012-12-31 | $37,381 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2012-12-31 | $37,381 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2012-12-31 | $57 |
| Value of funds held in insurance company general accounts (unallocated contracts) at end of year | 2012-12-31 | $0 |
| Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year | 2012-12-31 | $40,204 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2012-12-31 | No |
| Was there a failure to transmit to the plan any participant contributions | 2012-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2012-12-31 | No |
| Contributions received in cash from employer | 2012-12-31 | $969,948 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2012-12-31 | $1,019,424 |
| Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2012-12-31 | No |
| Did the plan have assets held for investment | 2012-12-31 | No |
| 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 | 2012-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2012-12-31 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2012-12-31 | No |
| Opinion of an independent qualified public accountant for this plan | 2012-12-31 | Unqualified |
| Accountancy firm name | 2012-12-31 | LOTT, VERNON & COMPANY, PC |
| Accountancy firm EIN | 2012-12-31 | 742484378 |
| 2015: SCOTT & WHITE HEALTHCARE EMPLOYEE WELFARE BENEFITS PLAN 2015 form 5500 responses | ||
|---|---|---|
| 2015-01-01 | Type of plan entity | Single employer plan |
| 2015-01-01 | This submission is the final filing | Yes |
| 2015-01-01 | Plan funding arrangement – Insurance | Yes |
| 2015-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2014: SCOTT & WHITE HEALTHCARE EMPLOYEE WELFARE BENEFITS PLAN 2014 form 5500 responses | ||
| 2014-01-01 | Type of plan entity | Single employer plan |
| 2014-01-01 | Plan funding arrangement – Insurance | Yes |
| 2014-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2013: SCOTT & WHITE HEALTHCARE EMPLOYEE WELFARE BENEFITS PLAN 2013 form 5500 responses | ||
| 2013-01-01 | Type of plan entity | Single employer plan |
| 2013-01-01 | Submission has been amended | Yes |
| 2013-01-01 | Plan funding arrangement – Insurance | Yes |
| 2013-01-01 | Plan funding arrangement – Trust | Yes |
| 2013-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2013-01-01 | Plan benefit arrangement - Trust | Yes |
| 2012: SCOTT & WHITE HEALTHCARE EMPLOYEE WELFARE BENEFITS PLAN 2012 form 5500 responses | ||
| 2012-01-01 | Type of plan entity | Single employer plan |
| 2012-01-01 | Plan funding arrangement – Insurance | Yes |
| 2012-01-01 | Plan funding arrangement – Trust | Yes |
| 2012-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2012-01-01 | Plan benefit arrangement - Trust | Yes |
| FEDERAL INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 20281 ) | |
| Policy contract number | 99072528 |
| Policy instance | 10 |
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) | |
| Policy contract number | 767587G |
| Policy instance | 1 |
| HYATT LEGAL PLANS (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | 6720010 |
| Policy instance | 2 |
| LIBERTY LIFE ASSURANCE COMPANY OF BOSTON (National Association of Insurance Commissioners NAIC id number: 65315 ) | |
| Policy contract number | GF385029053301 |
| Policy instance | 3 |
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) | |
| Policy contract number | 112817 |
| Policy instance | 4 |
| MINNESOTA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66168 ) | |
| Policy contract number | 34012 |
| Policy instance | 5 |
| MINNESOTA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66168 ) | |
| Policy contract number | 34012 |
| Policy instance | 6 |
| MINNESOTA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66168 ) | |
| Policy contract number | 34013 |
| Policy instance | 7 |
| NATIONAL GUARDIAN LIFE (National Association of Insurance Commissioners NAIC id number: 66583 ) | |
| Policy contract number | 27165 |
| Policy instance | 8 |
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) | |
| Policy contract number | 543656 |
| Policy instance | 9 |
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) | |
| Policy contract number | 767587G |
| Policy instance | 2 |
| HYATT LEGAL PLANS (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | 6720010 |
| Policy instance | 3 |
| LIBERTY LIFE ASSURANCE COMPANY OF BOSTON (National Association of Insurance Commissioners NAIC id number: 65315 ) | |
| Policy contract number | GF385029053301 |
| Policy instance | 4 |
| LIBERTY LIFE ASSURANCE COMPANY OF BOSTON (National Association of Insurance Commissioners NAIC id number: 65315 ) | |
| Policy contract number | PD3-850-290533- |
| Policy instance | 5 |
| MINNESOTA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66168 ) | |
| Policy contract number | 34012 |
| Policy instance | 7 |
| MINNESOTA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66168 ) | |
| Policy contract number | 34013 |
| Policy instance | 9 |
| MINNESOTA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66168 ) | |
| Policy contract number | 34012 |
| Policy instance | 8 |
| NATIONAL GUARDIAN LIFE (National Association of Insurance Commissioners NAIC id number: 66583 ) | |
| Policy contract number | 27165 |
| Policy instance | 10 |
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) | |
| Policy contract number | 543656 |
| Policy instance | 11 |
| FEDERAL INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 20281 ) | |
| Policy contract number | 99072528 |
| Policy instance | 12 |
| DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 ) | |
| Policy contract number | F019102 |
| Policy instance | 1 |
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) | |
| Policy contract number | 112817 |
| Policy instance | 6 |
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) | |
| Policy contract number | 112817 |
| Policy instance | 10 |
| DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 ) | |
| Policy contract number | F019102 |
| Policy instance | 1 |
| FEDERAL INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 20281 ) | |
| Policy contract number | 99072528 |
| Policy instance | 2 |
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) | |
| Policy contract number | 767587G |
| Policy instance | 3 |
| HYATT LEGAL PLANS (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | 6720010 |
| Policy instance | 4 |
| LIBERTY LIFE ASSURANCE COMPANY OF BOSTON (National Association of Insurance Commissioners NAIC id number: 65315 ) | |
| Policy contract number | GF385029053301 |
| Policy instance | 5 |
| MINNESOTA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66168 ) | |
| Policy contract number | 34012 |
| Policy instance | 6 |
| MINNESOTA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66168 ) | |
| Policy contract number | 34012 |
| Policy instance | 7 |
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) | |
| Policy contract number | 543656 |
| Policy instance | 9 |
| MINNESOTA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66168 ) | |
| Policy contract number | 34013 |
| Policy instance | 8 |
| NATIONAL GUARDIAN LIFE (National Association of Insurance Commissioners NAIC id number: 66583 ) | |
| Policy contract number | 30285 |
| Policy instance | 11 |
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) | |
| Policy contract number | 112817 |
| Policy instance | 2 |
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) | |
| Policy contract number | 767587G |
| Policy instance | 3 |
| DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 ) | |
| Policy contract number | F019102 |
| Policy instance | 4 |
| HYATT LEGAL PLANS (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | 6720010 |
| Policy instance | 5 |
| LIBERTY LIFE ASSURANCE COMPANY OF BOSTON (National Association of Insurance Commissioners NAIC id number: 65315 ) | |
| Policy contract number | GF385029053301 |
| Policy instance | 6 |
| MINNESOTA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66168 ) | |
| Policy contract number | 34012 |
| Policy instance | 7 |
| MINNESOTA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66168 ) | |
| Policy contract number | 34012 |
| Policy instance | 8 |
| MINNESOTA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66168 ) | |
| Policy contract number | 34013 |
| Policy instance | 9 |
| NATIONAL GUARDIAN LIFE (National Association of Insurance Commissioners NAIC id number: 66583 ) | |
| Policy contract number | 30285 |
| Policy instance | 10 |
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) | |
| Policy contract number | 543656 |
| Policy instance | 1 |
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