401k Plan data: SHARE OUR STRENGTH HEALTH PLAN plan

SHARE OUR STRENGTH HEALTH PLAN 401k Plan overview

Plan Name	SHARE OUR STRENGTH HEALTH PLAN
Plan identification number	501

SHARE OUR STRENGTH HEALTH PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) Other welfare benefit cover

401k Sponsoring company profile

SHARE OUR STRENGTH has sponsored the creation of one or more 401k plans.

Company Name: SHARE OUR STRENGTH

Employer identification number (EIN): 521367538

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

Additional information about SHARE OUR STRENGTH

Jurisdiction of Incorporation: State of Delaware Division of Corporations

Incorporation Date:

Company Identification Number: 2325745

More information about SHARE OUR STRENGTH

Form 5500 Filing Information

Submission information for form 5500 for 401k plan SHARE OUR STRENGTH HEALTH PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2012-01-01 JOHN GREEN
501 2011-12-01 JOHN GREEN

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
501	2012-01-01	JOHN GREEN
501	2011-12-01	JOHN GREEN

Plan Statistics for SHARE OUR STRENGTH HEALTH PLAN

401k plan membership statisitcs for SHARE OUR STRENGTH HEALTH PLAN

Measure Date Value
2012: SHARE OUR STRENGTH HEALTH PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 135
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 0
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 0
2011: SHARE OUR STRENGTH HEALTH PLAN 2011 401k membership
Total participants, beginning-of-year 2011-12-01 122
Total number of active participants reported on line 7a of the Form 5500 2011-12-01 121
Number of retired or separated participants receiving benefits 2011-12-01 1
Number of other retired or separated participants entitled to future benefits 2011-12-01 0
Total of all active and inactive participants 2011-12-01 122

Measure	Date	Value
2012: SHARE OUR STRENGTH HEALTH PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	135
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	0
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	0
2011: SHARE OUR STRENGTH HEALTH PLAN 2011 401k membership
Total participants, beginning-of-year	2011-12-01	122
Total number of active participants reported on line 7a of the Form 5500	2011-12-01	121
Number of retired or separated participants receiving benefits	2011-12-01	1
Number of other retired or separated participants entitled to future benefits	2011-12-01	0
Total of all active and inactive participants	2011-12-01	122

Form 5500 Responses for SHARE OUR STRENGTH HEALTH PLAN

2012: SHARE OUR STRENGTH HEALTH 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	Yes
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 benefit arrangement – Insurance	Yes
2011: SHARE OUR STRENGTH HEALTH PLAN 2011 form 5500 responses
2011-12-01	Type of plan entity	Single employer plan
2011-12-01	First time form 5500 has been submitted	Yes
2011-12-01	Submission has been amended	No
2011-12-01	This submission is the final filing	No
2011-12-01	This return/report is a short plan year return/report (less than 12 months)	Yes
2011-12-01	Plan is a collectively bargained plan	No
2011-12-01	Plan funding arrangement – Insurance	Yes
2011-12-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

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

Policy contract number

743498

Policy instance

Insurance contract or identification number	743498
Number of Individuals Covered	257
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $31,738
Total amount of fees paid to insurance company	USD $847
Are there contracts with allocated funds for individual policies?	No
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	Yes
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
Welfare Benefit Premiums Paid to Carrier	USD $911,029
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $31,738
Amount paid for insurance broker fees	847
Additional information about fees paid to insurance broker	BONUS
Insurance broker organization code?	3
Insurance broker name	THE MELTZER GROUP

GHMSI (National Association of Insurance Commissioners NAIC id number: 53007 )

Policy contract number

WD85

Policy instance

Insurance contract or identification number	WD85
Number of Individuals Covered	132
Insurance policy start date	2011-12-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $3,512
Total amount of fees paid to insurance company	USD $853
Are there contracts with allocated funds for individual policies?	No
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	Yes
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
Welfare Benefit Premiums Paid to Carrier	USD $70,285
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

Potentially related plans

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Company Name:	SHARE OUR STRENGTH
Employer identification number (EIN):	521367538
NAIC Classification:	813000
NAIC Description:	Religious, Grantmaking, Civic, Professional, and Similar Organizations

Jurisdiction of Incorporation:	State of Delaware Division of Corporations
Incorporation Date:
Company Identification Number:	2325745