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BLUEGRASS HEALTH PARTNERS EMPLOYEE BENEFIT PLAN 401k Plan overview

Plan NameBLUEGRASS HEALTH PARTNERS EMPLOYEE BENEFIT PLAN
Plan identification number 501

BLUEGRASS HEALTH PARTNERS EMPLOYEE BENEFIT PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Vision

401k Sponsoring company profile

VALLEY STREAM OPERATOR 1 LLC DBA BLUEGRASS HEALTH PARTNERS has sponsored the creation of one or more 401k plans.

Company Name:VALLEY STREAM OPERATOR 1 LLC DBA BLUEGRASS HEALTH PARTNERS
Employer identification number (EIN):811010658
NAIC Classification:623000
NAIC Description: Nursing and Residential Care Facilities

Form 5500 Filing Information

Submission information for form 5500 for 401k plan BLUEGRASS HEALTH PARTNERS EMPLOYEE BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012022-02-01
5012017-02-01VALERIE PATE
5012016-08-01JOHN DAILEY

Plan Statistics for BLUEGRASS HEALTH PARTNERS EMPLOYEE BENEFIT PLAN

401k plan membership statisitcs for BLUEGRASS HEALTH PARTNERS EMPLOYEE BENEFIT PLAN

Measure Date Value
2022: BLUEGRASS HEALTH PARTNERS EMPLOYEE BENEFIT PLAN 2022 401k membership
Total participants, beginning-of-year2022-02-01363
Total number of active participants reported on line 7a of the Form 55002022-02-01374
Total of all active and inactive participants2022-02-01374
Total participants2022-02-01374
2017: BLUEGRASS HEALTH PARTNERS EMPLOYEE BENEFIT PLAN 2017 401k membership
Total participants, beginning-of-year2017-02-01709
Total number of active participants reported on line 7a of the Form 55002017-02-01657
Number of retired or separated participants receiving benefits2017-02-014
Number of other retired or separated participants entitled to future benefits2017-02-010
Total of all active and inactive participants2017-02-01661
2016: BLUEGRASS HEALTH PARTNERS EMPLOYEE BENEFIT PLAN 2016 401k membership
Total participants, beginning-of-year2016-08-01644
Total number of active participants reported on line 7a of the Form 55002016-08-01657
Number of retired or separated participants receiving benefits2016-08-016
Number of other retired or separated participants entitled to future benefits2016-08-010
Total of all active and inactive participants2016-08-01663

Financial Data on BLUEGRASS HEALTH PARTNERS EMPLOYEE BENEFIT PLAN

Measure Date Value
2023 : BLUEGRASS HEALTH PARTNERS EMPLOYEE BENEFIT PLAN 2023 401k financial data
Total transfer of assets to this plan2023-01-31$400,000
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2023-01-31$530,797
Total income from all sources (including contributions)2023-01-31$2,687,049
Total of all expenses incurred2023-01-31$3,141,846
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2023-01-31$2,884,346
Total contributions o plan (from employers,participants, others, non cash contrinutions)2023-01-31$2,687,049
Value of total assets at end of year2023-01-31$476,000
Total of administrative expenses incurred including professional, contract, advisory and management fees2023-01-31$257,500
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2023-01-31No
Was this plan covered by a fidelity bond2023-01-31No
If this is an individual account plan, was there a blackout period2023-01-31No
Were there any nonexempt tranactions with any party-in-interest2023-01-31No
Contributions received from participants2023-01-31$648,332
Total non interest bearing cash at end of year2023-01-31$476,000
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2023-01-31No
Value of net income/loss2023-01-31$-454,797
Value of net assets at end of year (total assets less liabilities)2023-01-31$-54,797
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2023-01-31No
Were any loans by the plan or fixed income obligations due to the plan in default2023-01-31No
Were any leases to which the plan was party in default or uncollectible2023-01-31No
Value of interest in pooled separate accounts at end of year2023-01-31$0
Expenses. Payments to insurance carriers foe the provision of benefits2023-01-31$228,152
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2023-01-31Yes
Was there a failure to transmit to the plan any participant contributions2023-01-31No
Has the plan failed to provide any benefit when due under the plan2023-01-31No
Contributions received in cash from employer2023-01-31$2,038,717
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2023-01-31$2,656,194
Contract administrator fees2023-01-31$257,500
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32023-01-31No
Liabilities. Value of benefit claims payable at end of year2023-01-31$530,797
Did the plan have assets held for investment2023-01-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2023-01-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2023-01-31No
Opinion of an independent qualified public accountant for this plan2023-01-31Unqualified
Accountancy firm name2023-01-31FASTEN HALBERSTAM LLP
Accountancy firm EIN2023-01-31472319109

Form 5500 Responses for BLUEGRASS HEALTH PARTNERS EMPLOYEE BENEFIT PLAN

2022: BLUEGRASS HEALTH PARTNERS EMPLOYEE BENEFIT PLAN 2022 form 5500 responses
2022-02-01Type of plan entitySingle employer plan
2022-02-01Plan funding arrangement – TrustYes
2022-02-01Plan benefit arrangement – InsuranceYes
2022-02-01Plan benefit arrangement - TrustYes
2017: BLUEGRASS HEALTH PARTNERS EMPLOYEE BENEFIT PLAN 2017 form 5500 responses
2017-02-01Type of plan entitySingle employer plan
2017-02-01Submission has been amendedNo
2017-02-01This submission is the final filingNo
2017-02-01This return/report is a short plan year return/report (less than 12 months)No
2017-02-01Plan is a collectively bargained planNo
2017-02-01Plan funding arrangement – InsuranceYes
2017-02-01Plan benefit arrangement – InsuranceYes
2016: BLUEGRASS HEALTH PARTNERS EMPLOYEE BENEFIT PLAN 2016 form 5500 responses
2016-08-01Type of plan entitySingle employer plan
2016-08-01Submission has been amendedNo
2016-08-01This submission is the final filingNo
2016-08-01This return/report is a short plan year return/report (less than 12 months)Yes
2016-08-01Plan is a collectively bargained planNo
2016-08-01Plan funding arrangement – InsuranceYes
2016-08-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

SUN LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80926 )
Policy contract number824682
Policy instance 1
Insurance contract or identification number824682
Number of Individuals Covered630
Insurance policy start date2022-02-01
Insurance policy end date2023-01-31
Total amount of commissions paid to insurance brokerUSD $44,935
Welfare Benefit Premiums Paid to CarrierUSD $228,152
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $44,935
Insurance broker organization code?3
ANTHEM HEALTH PLAN OF KENTUCKY D.B.A. ANTHEM BLUECROSS BLUESHIELD (National Association of Insurance Commissioners NAIC id number: 95120 )
Policy contract number9545
Policy instance 1
Insurance contract or identification number9545
Number of Individuals Covered1098
Insurance policy start date2017-02-01
Insurance policy end date2018-01-31
Total amount of commissions paid to insurance brokerUSD $15,251
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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 CarrierUSD $57,140
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $15,134
Insurance broker organization code?3
Insurance broker nameINSURANCE SOLUTIONS OF KY, INC.
ANTHEM HEALTH PLAN OF KENTUCKY D.B.A. ANTHEM BLUECROSS BLUESHIELD (National Association of Insurance Commissioners NAIC id number: 95120 )
Policy contract numberA74524
Policy instance 2
Insurance contract or identification numberA74524
Number of Individuals Covered50
Insurance policy start date2017-06-01
Insurance policy end date2018-01-31
Total amount of commissions paid to insurance brokerUSD $8,535
Total amount of fees paid to insurance companyUSD $4,167
Are there contracts with allocated funds for individual policies?0
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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 CarrierUSD $190,606
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,535
Amount paid for insurance broker fees4167
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
Insurance broker nameMEDLINK INC

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