401k Plan data: UNIVERSITY HEALTHSYSTEM CONSORTIUM GROUP LIFE AND AD&D PLAN plan

UNIVERSITY HEALTHSYSTEM CONSORTIUM GROUP LIFE AND AD&D PLAN 401k Plan overview

Plan Name	UNIVERSITY HEALTHSYSTEM CONSORTIUM GROUP LIFE AND AD&D PLAN
Plan identification number	501

UNIVERSITY HEALTHSYSTEM CONSORTIUM GROUP LIFE AND AD&D PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) Life insurance Dental Vision Temporary disability (accident and sickness) Long-term disability cover Death benefits (include travel accident but not life insurance) Other welfare benefit cover

401k Sponsoring company profile

UNIVERSITY HEALTHSYSTEM CONSORTIUM has sponsored the creation of one or more 401k plans.

Company Name: UNIVERSITY HEALTHSYSTEM CONSORTIUM

Employer identification number (EIN): 363740243

NAIC Classification: 813000
NAIC Description: Religious, Grantmaking, Civic, Professional, and Similar Organizations

Form 5500 Filing Information

Submission information for form 5500 for 401k plan UNIVERSITY HEALTHSYSTEM CONSORTIUM GROUP LIFE AND AD&D PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2014-01-01 DANIEL R O'BRIEN
501 2013-01-01 DANIEL R O'BRIEN
501 2012-01-01 DANIEL R O'BRIEN
501 2011-01-01 DANIEL R O'BRIEN
501 2010-01-01 DANIEL R O'BRIEN
501 2009-01-01 DANIEL OBRIEN

Plan id#	Filing Submission Date	Name of Administrator
501	2014-01-01	DANIEL R O'BRIEN
501	2013-01-01	DANIEL R O'BRIEN
501	2012-01-01	DANIEL R O'BRIEN
501	2011-01-01	DANIEL R O'BRIEN
501	2010-01-01	DANIEL R O'BRIEN
501	2009-01-01	DANIEL OBRIEN

Plan Statistics for UNIVERSITY HEALTHSYSTEM CONSORTIUM GROUP LIFE AND AD&D PLAN

401k plan membership statisitcs for UNIVERSITY HEALTHSYSTEM CONSORTIUM GROUP LIFE AND AD&D PLAN

Measure Date Value
2014: UNIVERSITY HEALTHSYSTEM CONSORTIUM GROUP LIFE AND AD&D PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 297
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 311
Number of retired or separated participants receiving benefits 2014-01-01 0
Number of other retired or separated participants entitled to future benefits 2014-01-01 0
Total of all active and inactive participants 2014-01-01 311
2013: UNIVERSITY HEALTHSYSTEM CONSORTIUM GROUP LIFE AND AD&D PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 278
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 297
Number of retired or separated participants receiving benefits 2013-01-01 0
Number of other retired or separated participants entitled to future benefits 2013-01-01 0
Total of all active and inactive participants 2013-01-01 297
2012: UNIVERSITY HEALTHSYSTEM CONSORTIUM GROUP LIFE AND AD&D PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 256
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 278
Number of retired or separated participants receiving benefits 2012-01-01 0
Number of other retired or separated participants entitled to future benefits 2012-01-01 0
Total of all active and inactive participants 2012-01-01 278
2011: UNIVERSITY HEALTHSYSTEM CONSORTIUM GROUP LIFE AND AD&D PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 252
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 256
Number of retired or separated participants receiving benefits 2011-01-01 0
Number of other retired or separated participants entitled to future benefits 2011-01-01 0
Total of all active and inactive participants 2011-01-01 256
2010: UNIVERSITY HEALTHSYSTEM CONSORTIUM GROUP LIFE AND AD&D PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 256
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 252
Number of retired or separated participants receiving benefits 2010-01-01 0
Number of other retired or separated participants entitled to future benefits 2010-01-01 0
Total of all active and inactive participants 2010-01-01 252
2009: UNIVERSITY HEALTHSYSTEM CONSORTIUM GROUP LIFE AND AD&D PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 271
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 256
Number of retired or separated participants receiving benefits 2009-01-01 0
Number of other retired or separated participants entitled to future benefits 2009-01-01 0
Total of all active and inactive participants 2009-01-01 256

Measure	Date	Value
2014: UNIVERSITY HEALTHSYSTEM CONSORTIUM GROUP LIFE AND AD&D PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	297
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	311
Number of retired or separated participants receiving benefits	2014-01-01	0
Number of other retired or separated participants entitled to future benefits	2014-01-01	0
Total of all active and inactive participants	2014-01-01	311
2013: UNIVERSITY HEALTHSYSTEM CONSORTIUM GROUP LIFE AND AD&D PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	278
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	297
Number of retired or separated participants receiving benefits	2013-01-01	0
Number of other retired or separated participants entitled to future benefits	2013-01-01	0
Total of all active and inactive participants	2013-01-01	297
2012: UNIVERSITY HEALTHSYSTEM CONSORTIUM GROUP LIFE AND AD&D PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	256
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	278
Number of retired or separated participants receiving benefits	2012-01-01	0
Number of other retired or separated participants entitled to future benefits	2012-01-01	0
Total of all active and inactive participants	2012-01-01	278
2011: UNIVERSITY HEALTHSYSTEM CONSORTIUM GROUP LIFE AND AD&D PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	252
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	256
Number of retired or separated participants receiving benefits	2011-01-01	0
Number of other retired or separated participants entitled to future benefits	2011-01-01	0
Total of all active and inactive participants	2011-01-01	256
2010: UNIVERSITY HEALTHSYSTEM CONSORTIUM GROUP LIFE AND AD&D PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	256
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	252
Number of retired or separated participants receiving benefits	2010-01-01	0
Number of other retired or separated participants entitled to future benefits	2010-01-01	0
Total of all active and inactive participants	2010-01-01	252
2009: UNIVERSITY HEALTHSYSTEM CONSORTIUM GROUP LIFE AND AD&D PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	271
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	256
Number of retired or separated participants receiving benefits	2009-01-01	0
Number of other retired or separated participants entitled to future benefits	2009-01-01	0
Total of all active and inactive participants	2009-01-01	256

Form 5500 Responses for UNIVERSITY HEALTHSYSTEM CONSORTIUM GROUP LIFE AND AD&D PLAN

2014: UNIVERSITY HEALTHSYSTEM CONSORTIUM GROUP LIFE AND AD&D PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Submission has been amended	No
2014-01-01	This submission is the final filing	No
2014-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-01-01	Plan is a collectively bargained plan	No
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
2013: UNIVERSITY HEALTHSYSTEM CONSORTIUM GROUP LIFE AND AD&D PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Submission has been amended	No
2013-01-01	This submission is the final filing	No
2013-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-01-01	Plan is a collectively bargained plan	No
2013-01-01	Plan funding arrangement – Insurance	Yes
2013-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2013-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2012: UNIVERSITY HEALTHSYSTEM CONSORTIUM GROUP LIFE AND AD&D PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Submission has been amended	No
2012-01-01	This submission is the final filing	No
2012-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-01-01	Plan is a collectively bargained plan	No
2012-01-01	Plan funding arrangement – Insurance	Yes
2012-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2011: UNIVERSITY HEALTHSYSTEM CONSORTIUM GROUP LIFE AND AD&D PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Submission has been amended	No
2011-01-01	This submission is the final filing	No
2011-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-01-01	Plan is a collectively bargained plan	No
2011-01-01	Plan funding arrangement – Insurance	Yes
2011-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2011-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2010: UNIVERSITY HEALTHSYSTEM CONSORTIUM GROUP LIFE AND AD&D PLAN 2010 form 5500 responses
2010-01-01	Type of plan entity	Single employer plan
2010-01-01	Submission has been amended	No
2010-01-01	This submission is the final filing	No
2010-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2010-01-01	Plan is a collectively bargained plan	No
2010-01-01	Plan funding arrangement – Insurance	Yes
2010-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2010-01-01	Plan benefit arrangement – Insurance	Yes
2010-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2009: UNIVERSITY HEALTHSYSTEM CONSORTIUM GROUP LIFE AND AD&D PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	Submission has been amended	No
2009-01-01	This submission is the final filing	No
2009-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-01-01	Plan is a collectively bargained plan	No
2009-01-01	Plan funding arrangement – Insurance	Yes
2009-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2009-01-01	Plan benefit arrangement – Insurance	Yes
2009-01-01	Plan benefit arrangement – General assets of the sponsor	Yes

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Company Name:	UNIVERSITY HEALTHSYSTEM CONSORTIUM
Employer identification number (EIN):	363740243
NAIC Classification:	813000
NAIC Description:	Religious, Grantmaking, Civic, Professional, and Similar Organizations