401k Plan data: OHI WELFARE BENEFITS

OHI WELFARE BENEFITS - LIFE 401k Plan overview

Plan Name	OHI WELFARE BENEFITS - LIFE
Plan identification number	503

OHI WELFARE BENEFITS - LIFE Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Life insurance

401k Sponsoring company profile

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

Company Name: OHI

Employer identification number (EIN): 010362709

NAIC Classification: 624100
NAIC Description: Individual and Family Services

Form 5500 Filing Information

Submission information for form 5500 for 401k plan OHI WELFARE BENEFITS - LIFE

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
503 2016-01-01 TWILA TOMLIN TWILA TOMLIN 2017-11-10
503 2015-01-01 TWILA TOMLIN TWILA TOMLIN 2017-11-10
503 2014-01-01 TWILA TOMLIN TWILA TOMLIN 2017-11-10
503 2013-01-01 TWILA TOMLIN TWILA TOMLIN 2017-11-10
503 2012-01-01 TWILA TOMLIN TWILA TOMLIN 2017-11-10
503 2011-01-01 TWILA TOMLIN TWILA TOMLIN 2017-11-10
503 2011-01-01 TWILA TOMLIN 2017-11-10

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
503	2016-01-01	TWILA TOMLIN	TWILA TOMLIN	2017-11-10
503	2015-01-01	TWILA TOMLIN	TWILA TOMLIN	2017-11-10
503	2014-01-01	TWILA TOMLIN	TWILA TOMLIN	2017-11-10
503	2013-01-01	TWILA TOMLIN	TWILA TOMLIN	2017-11-10
503	2012-01-01	TWILA TOMLIN	TWILA TOMLIN	2017-11-10
503	2011-01-01	TWILA TOMLIN	TWILA TOMLIN	2017-11-10
503	2011-01-01		TWILA TOMLIN	2017-11-10

Plan Statistics for OHI WELFARE BENEFITS - LIFE

401k plan membership statisitcs for OHI WELFARE BENEFITS - LIFE

Measure Date Value
2016: OHI WELFARE BENEFITS - LIFE 2016 401k membership
Total participants, beginning-of-year 2016-01-01 253
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 496
Number of retired or separated participants receiving benefits 2016-01-01 0
Number of other retired or separated participants entitled to future benefits 2016-01-01 0
Total of all active and inactive participants 2016-01-01 496
Total participants 2016-01-01 496
2015: OHI WELFARE BENEFITS - LIFE 2015 401k membership
Total participants, beginning-of-year 2015-01-01 267
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 253
Number of retired or separated participants receiving benefits 2015-01-01 0
Number of other retired or separated participants entitled to future benefits 2015-01-01 0
Total of all active and inactive participants 2015-01-01 253
Total participants 2015-01-01 253
Number of employers contributing to the scheme 2015-01-01 0
2014: OHI WELFARE BENEFITS - LIFE 2014 401k membership
Total participants, beginning-of-year 2014-01-01 248
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 267
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 2014-01-01 267
Total participants 2014-01-01 267
Number of employers contributing to the scheme 2014-01-01 0
2013: OHI WELFARE BENEFITS - LIFE 2013 401k membership
Total participants, beginning-of-year 2013-01-01 240
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 248
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 2013-01-01 248
Total participants 2013-01-01 248
Number of employers contributing to the scheme 2013-01-01 0
2012: OHI WELFARE BENEFITS - LIFE 2012 401k membership
Total participants, beginning-of-year 2012-01-01 259
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 240
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 2012-01-01 240
Total participants 2012-01-01 240
Number of employers contributing to the scheme 2012-01-01 0
2011: OHI WELFARE BENEFITS - LIFE 2011 401k membership
Total participants, beginning-of-year 2011-01-01 266
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 259
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 2011-01-01 259
Total participants 2011-01-01 259
Number of employers contributing to the scheme 2011-01-01 0

Measure	Date	Value
2016: OHI WELFARE BENEFITS - LIFE 2016 401k membership
Total participants, beginning-of-year	2016-01-01	253
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	496
Number of retired or separated participants receiving benefits	2016-01-01	0
Number of other retired or separated participants entitled to future benefits	2016-01-01	0
Total of all active and inactive participants	2016-01-01	496
Total participants	2016-01-01	496
2015: OHI WELFARE BENEFITS - LIFE 2015 401k membership
Total participants, beginning-of-year	2015-01-01	267
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	253
Number of retired or separated participants receiving benefits	2015-01-01	0
Number of other retired or separated participants entitled to future benefits	2015-01-01	0
Total of all active and inactive participants	2015-01-01	253
Total participants	2015-01-01	253
Number of employers contributing to the scheme	2015-01-01	0
2014: OHI WELFARE BENEFITS - LIFE 2014 401k membership
Total participants, beginning-of-year	2014-01-01	248
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	267
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	267
Total participants	2014-01-01	267
Number of employers contributing to the scheme	2014-01-01	0
2013: OHI WELFARE BENEFITS - LIFE 2013 401k membership
Total participants, beginning-of-year	2013-01-01	240
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	248
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	248
Total participants	2013-01-01	248
Number of employers contributing to the scheme	2013-01-01	0
2012: OHI WELFARE BENEFITS - LIFE 2012 401k membership
Total participants, beginning-of-year	2012-01-01	259
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	240
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	240
Total participants	2012-01-01	240
Number of employers contributing to the scheme	2012-01-01	0
2011: OHI WELFARE BENEFITS - LIFE 2011 401k membership
Total participants, beginning-of-year	2011-01-01	266
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	259
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	259
Total participants	2011-01-01	259
Number of employers contributing to the scheme	2011-01-01	0

Form 5500 Responses for OHI WELFARE BENEFITS - LIFE

2016: OHI WELFARE BENEFITS - LIFE 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	First time form 5500 has been submitted	Yes
2016-01-01	Submission has been amended	No
2016-01-01	This submission is the final filing	No
2016-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-01-01	Plan is a collectively bargained plan	No
2016-01-01	Plan funding arrangement – Insurance	Yes
2016-01-01	Plan benefit arrangement – Insurance	Yes
2015: OHI WELFARE BENEFITS - LIFE 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	First time form 5500 has been submitted	Yes
2015-01-01	Submission has been amended	No
2015-01-01	This submission is the final filing	No
2015-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-01-01	Plan is a collectively bargained plan	No
2015-01-01	Plan funding arrangement – Insurance	Yes
2015-01-01	Plan benefit arrangement – Insurance	Yes
2014: OHI WELFARE BENEFITS - LIFE 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	No
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 – Insurance	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes
2013: OHI WELFARE BENEFITS - LIFE 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	First time form 5500 has been submitted	Yes
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 – Insurance	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2012: OHI WELFARE BENEFITS - LIFE 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	First time form 5500 has been submitted	Yes
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 – Insurance	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2011: OHI WELFARE BENEFITS - LIFE 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	First time form 5500 has been submitted	Yes
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 – Insurance	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes

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Company Name:	OHI
Employer identification number (EIN):	010362709
NAIC Classification:	624100
NAIC Description:	Individual and Family Services