401k Plan data: NORTH MISSISSIPPI HEALTH SERVICES, INC. EMPLOYEE BENEFITS PLAN plan

NORTH MISSISSIPPI HEALTH SERVICES, INC. EMPLOYEE BENEFITS PLAN 401k Plan overview

Plan Name	NORTH MISSISSIPPI HEALTH SERVICES, INC. EMPLOYEE BENEFITS PLAN
Plan identification number	501

NORTH MISSISSIPPI HEALTH SERVICES, INC. EMPLOYEE BENEFITS PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) Life insurance Dental Vision Long-term disability cover Other welfare benefit cover

401k Sponsoring company profile

NORTH MISSISSIPPI HEALTH SERVICES, INC. has sponsored the creation of one or more 401k plans.

Company Name: NORTH MISSISSIPPI HEALTH SERVICES, INC.

Employer identification number (EIN): 640653269

NAIC Classification: 621112
NAIC Description: Offices of Physicians, Mental Health Specialists

Form 5500 Filing Information

Submission information for form 5500 for 401k plan NORTH MISSISSIPPI HEALTH SERVICES, INC. EMPLOYEE BENEFITS PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2023-01-01 SONDRA DAVIS 2024-07-25

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
501	2023-01-01	SONDRA DAVIS	2024-07-25

Form 5500 Responses for NORTH MISSISSIPPI HEALTH SERVICES, INC. EMPLOYEE BENEFITS PLAN

2023: NORTH MISSISSIPPI HEALTH SERVICES, INC. EMPLOYEE BENEFITS PLAN 2023 form 5500 responses
2023-01-01	Type of plan entity	Single employer plan
2023-01-01	First time form 5500 has been submitted	Yes
2023-01-01	Plan funding arrangement – Insurance	Yes
2023-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2023-01-01	Plan benefit arrangement – Insurance	Yes
2023-01-01	Plan benefit arrangement – General assets of the sponsor	Yes

Insurance Providers Used on plan

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

GF3-890-LF0191

Policy instance

Insurance contract or identification number	GF3-890-LF0191
Number of Individuals Covered	4607
Insurance policy start date	2023-01-01
Insurance policy end date	2023-12-31
Total amount of commissions paid to insurance broker	USD $37,911
Total amount of fees paid to insurance company	USD $50,042
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $668,213
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

SA3-890-LF0191

Policy instance

Insurance contract or identification number	SA3-890-LF0191
Number of Individuals Covered	5498
Insurance policy start date	2023-01-01
Insurance policy end date	2023-12-31
Total amount of commissions paid to insurance broker	USD $72,684
Total amount of fees paid to insurance company	USD $89,041
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $1,294,032
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 )

Policy contract number

71089-0

Policy instance

Insurance contract or identification number	71089-0
Number of Individuals Covered	4080
Insurance policy start date	2023-01-01
Insurance policy end date	2023-12-31
Total amount of commissions paid to insurance broker	USD $244,477
Total amount of fees paid to insurance company	USD $36,104
Other welfare benefits provided	ACCIDENT,CRIT. ILLNESS,HOSP. CONFIN
Welfare Benefit Premiums Paid to Carrier	USD $902,610
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 )

Policy contract number

G2009

Policy instance

Insurance contract or identification number	G2009
Number of Individuals Covered	985
Insurance policy start date	2023-01-01
Insurance policy end date	2023-12-31
Total amount of commissions paid to insurance broker	USD $72,305
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $508,787
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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Company Name:	NORTH MISSISSIPPI HEALTH SERVICES, INC.
Employer identification number (EIN):	640653269
NAIC Classification:	621112
NAIC Description:	Offices of Physicians, Mental Health Specialists