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FIRST NATIONAL HEALTH SERVICES, LLC WELFARE BENEFIT PLAN 401k Plan overview

Plan NameFIRST NATIONAL HEALTH SERVICES, LLC WELFARE BENEFIT PLAN
Plan identification number 501

FIRST NATIONAL HEALTH SERVICES, LLC WELFARE BENEFIT PLAN Benefits

401k Plan TypeWelfare 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

FIRST NATIONAL HEALTH SERVICES, LLC has sponsored the creation of one or more 401k plans.

Company Name:FIRST NATIONAL HEALTH SERVICES, LLC
Employer identification number (EIN):871955856
NAIC Classification:621900

Form 5500 Filing Information

Submission information for form 5500 for 401k plan FIRST NATIONAL HEALTH SERVICES, LLC WELFARE BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012023-01-01JOSEPH ANDERSON2024-09-03

Form 5500 Responses for FIRST NATIONAL HEALTH SERVICES, LLC WELFARE BENEFIT PLAN

2023: FIRST NATIONAL HEALTH SERVICES, LLC WELFARE BENEFIT PLAN 2023 form 5500 responses
2023-01-01Type of plan entitySingle employer plan
2023-01-01First time form 5500 has been submittedYes
2023-01-01Plan funding arrangement – InsuranceYes
2023-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

REGENCE BLUECROSS BLUESHIELD OF UTAH (National Association of Insurance Commissioners NAIC id number: 54550 )
Policy contract number10055976
Policy instance 1
Insurance contract or identification number10055976
Number of Individuals Covered278
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $94,470
Total amount of fees paid to insurance companyUSD $7,280
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,898,367
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MONY (National Association of Insurance Commissioners NAIC id number: 78077 )
Policy contract number14417
Policy instance 2
Insurance contract or identification number14417
Number of Individuals Covered166
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $37,792
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT, ACCIDENT, CRITICAL ILLNESS, HOSPITAL
Welfare Benefit Premiums Paid to CarrierUSD $278,382
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
UNITED HEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract numberFIRST NATIONAL
Policy instance 3
Insurance contract or identification numberFIRST NATIONAL
Number of Individuals Covered122
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedEMPLOYEE ASSISTANCE PROGRAM
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes

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