401k Plan data: DIGNITY HEALTH SHORT TERM DISABILITY PLAN plan

DIGNITY HEALTH SHORT TERM DISABILITY PLAN 401k Plan overview

Plan Name	DIGNITY HEALTH SHORT TERM DISABILITY PLAN
Plan identification number	512

DIGNITY HEALTH SHORT TERM DISABILITY PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Temporary disability (accident and sickness)

401k Sponsoring company profile

DIGNITY HEALTH has sponsored the creation of one or more 401k plans.

Company Name: DIGNITY HEALTH

Employer identification number (EIN): 941196203

NAIC Classification: 622000
NAIC Description: Hospitals

Additional information about DIGNITY HEALTH

Jurisdiction of Incorporation: California Department of State

Incorporation Date: 1954-10-11

Company Identification Number: C0292448

Legal Registered Office Address: 185 Berry St Ste 300

San Francisco
United States of America (USA)
94107

More information about DIGNITY HEALTH

Form 5500 Filing Information

Submission information for form 5500 for 401k plan DIGNITY HEALTH SHORT TERM DISABILITY PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
512 2014-01-01 KAREN ZELENAK
512 2013-01-01 KAREN ZELENAK, BENEFITS DIRECTOR KAREN ZELENAK, BENEFITS DIRECTOR 2014-07-07
512 2012-01-01 KAREN ZELENAK, BENEFITS DIRECTOR KAREN ZELENAK, BENEFITS DIRECTOR 2013-07-25
512 2011-01-01 KAREN ZELENAK, BENEFITS DIRECTOR KAREN ZELENAK, BENEFITS DIRECTOR 2012-09-12
512 2009-01-01 ANTELL MITCHELL-JAMES, VP COMP BEN ANTELL MITCHELL-JAMES, VP COMP BEN 2010-10-05

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
512	2014-01-01	KAREN ZELENAK
512	2013-01-01	KAREN ZELENAK, BENEFITS DIRECTOR	KAREN ZELENAK, BENEFITS DIRECTOR	2014-07-07
512	2012-01-01	KAREN ZELENAK, BENEFITS DIRECTOR	KAREN ZELENAK, BENEFITS DIRECTOR	2013-07-25
512	2011-01-01	KAREN ZELENAK, BENEFITS DIRECTOR	KAREN ZELENAK, BENEFITS DIRECTOR	2012-09-12
512	2009-01-01	ANTELL MITCHELL-JAMES, VP COMP BEN	ANTELL MITCHELL-JAMES, VP COMP BEN	2010-10-05

Plan Statistics for DIGNITY HEALTH SHORT TERM DISABILITY PLAN

401k plan membership statisitcs for DIGNITY HEALTH SHORT TERM DISABILITY PLAN

Measure Date Value
2014: DIGNITY HEALTH SHORT TERM DISABILITY PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 2,143
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 0
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 0
2013: DIGNITY HEALTH SHORT TERM DISABILITY PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 2,571
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 2,143
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 2,143
2012: DIGNITY HEALTH SHORT TERM DISABILITY PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 1,957
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 2,571
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 2,571
2011: DIGNITY HEALTH SHORT TERM DISABILITY PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 1,970
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 1,957
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 1,957
2009: DIGNITY HEALTH SHORT TERM DISABILITY PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 1,078
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 1,860
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 1,860

Measure	Date	Value
2014: DIGNITY HEALTH SHORT TERM DISABILITY PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	2,143
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	0
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	0
2013: DIGNITY HEALTH SHORT TERM DISABILITY PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	2,571
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	2,143
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	2,143
2012: DIGNITY HEALTH SHORT TERM DISABILITY PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	1,957
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	2,571
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	2,571
2011: DIGNITY HEALTH SHORT TERM DISABILITY PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	1,970
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	1,957
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	1,957
2009: DIGNITY HEALTH SHORT TERM DISABILITY PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	1,078
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	1,860
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	1,860

Form 5500 Responses for DIGNITY HEALTH SHORT TERM DISABILITY PLAN

2014: DIGNITY HEALTH SHORT TERM DISABILITY 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	Yes
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 – General assets of the sponsor	Yes
2014-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2013: DIGNITY HEALTH SHORT TERM DISABILITY 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 – General assets of the sponsor	Yes
2013-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2012: DIGNITY HEALTH SHORT TERM DISABILITY 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 – General assets of the sponsor	Yes
2012-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2011: DIGNITY HEALTH SHORT TERM DISABILITY 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 – General assets of the sponsor	Yes
2011-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2009: DIGNITY HEALTH SHORT TERM DISABILITY 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 – General assets of the sponsor	Yes
2009-01-01	Plan benefit arrangement – General assets of the sponsor	Yes

Potentially related plans

DIGNITY HEALTH BEHAVIORAL SERVICE [EIN = 850953814]

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Company Name:	DIGNITY HEALTH
Employer identification number (EIN):	941196203
NAIC Classification:	622000
NAIC Description:	Hospitals

Jurisdiction of Incorporation:	California Department of State
Incorporation Date:	1954-10-11
Company Identification Number:	C0292448
Legal Registered Office Address:	185 Berry St Ste 300 San Francisco United States of America (USA) 94107