401k Plan data: LUTHERAN LIVING SERVICES REIMBURSEMENT ARRANGEMENT plan

LUTHERAN LIVING SERVICES REIMBURSEMENT ARRANGEMENT 401k Plan overview

Plan Name	LUTHERAN LIVING SERVICES REIMBURSEMENT ARRANGEMENT
Plan identification number	504

LUTHERAN LIVING SERVICES REIMBURSEMENT ARRANGEMENT Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) Unfunded, fully insured, or combination unfunded/insured welfare plan that will not file a Form 5500 for next plan year pursuant to 29 CFR 2520.104-20.

401k Sponsoring company profile

LUTHERAN LIVING SERVICES has sponsored the creation of one or more 401k plans.

Company Name: LUTHERAN LIVING SERVICES

Employer identification number (EIN): 390807205

NAIC Classification: 623000
NAIC Description: Nursing and Residential Care Facilities

Form 5500 Filing Information

Submission information for form 5500 for 401k plan LUTHERAN LIVING SERVICES REIMBURSEMENT ARRANGEMENT

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
504 2014-01-01 SHARON BRAUN
504 2013-01-01 SHARON BRAUN SHARON BRAUN 2014-07-28
504 2012-01-01 SHARON BRAUN SHARON BRAUN 2013-10-14
504 2011-01-01 SHARON BRAUN SHARON BRAUN 2012-07-20

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
504	2014-01-01	SHARON BRAUN
504	2013-01-01	SHARON BRAUN	SHARON BRAUN	2014-07-28
504	2012-01-01	SHARON BRAUN	SHARON BRAUN	2013-10-14
504	2011-01-01	SHARON BRAUN	SHARON BRAUN	2012-07-20

Plan Statistics for LUTHERAN LIVING SERVICES REIMBURSEMENT ARRANGEMENT

401k plan membership statisitcs for LUTHERAN LIVING SERVICES REIMBURSEMENT ARRANGEMENT

Measure Date Value
2014: LUTHERAN LIVING SERVICES REIMBURSEMENT ARRANGEMENT 2014 401k membership
Total participants, beginning-of-year 2014-01-01 192
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: LUTHERAN LIVING SERVICES REIMBURSEMENT ARRANGEMENT 2013 401k membership
Total participants, beginning-of-year 2013-01-01 180
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 181
Total of all active and inactive participants 2013-01-01 181
2012: LUTHERAN LIVING SERVICES REIMBURSEMENT ARRANGEMENT 2012 401k membership
Total participants, beginning-of-year 2012-01-01 212
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 178
Total of all active and inactive participants 2012-01-01 178
2011: LUTHERAN LIVING SERVICES REIMBURSEMENT ARRANGEMENT 2011 401k membership
Total participants, beginning-of-year 2011-01-01 227
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 212
Total of all active and inactive participants 2011-01-01 212

Measure	Date	Value
2014: LUTHERAN LIVING SERVICES REIMBURSEMENT ARRANGEMENT 2014 401k membership
Total participants, beginning-of-year	2014-01-01	192
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: LUTHERAN LIVING SERVICES REIMBURSEMENT ARRANGEMENT 2013 401k membership
Total participants, beginning-of-year	2013-01-01	180
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	181
Total of all active and inactive participants	2013-01-01	181
2012: LUTHERAN LIVING SERVICES REIMBURSEMENT ARRANGEMENT 2012 401k membership
Total participants, beginning-of-year	2012-01-01	212
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	178
Total of all active and inactive participants	2012-01-01	178
2011: LUTHERAN LIVING SERVICES REIMBURSEMENT ARRANGEMENT 2011 401k membership
Total participants, beginning-of-year	2011-01-01	227
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	212
Total of all active and inactive participants	2011-01-01	212

Form 5500 Responses for LUTHERAN LIVING SERVICES REIMBURSEMENT ARRANGEMENT

2014: LUTHERAN LIVING SERVICES REIMBURSEMENT ARRANGEMENT 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: LUTHERAN LIVING SERVICES REIMBURSEMENT ARRANGEMENT 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: LUTHERAN LIVING SERVICES REIMBURSEMENT ARRANGEMENT 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: LUTHERAN LIVING SERVICES REIMBURSEMENT ARRANGEMENT 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	Yes
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

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Company Name:	LUTHERAN LIVING SERVICES
Employer identification number (EIN):	390807205
NAIC Classification:	623000
NAIC Description:	Nursing and Residential Care Facilities