401k Plan data: DEAN HEALTH SYSTEMS, INC. GROUP LIFE INSURANCE PLAN plan

DEAN HEALTH SYSTEMS, INC. GROUP LIFE INSURANCE PLAN 401k Plan overview

Plan Name	DEAN HEALTH SYSTEMS, INC. GROUP LIFE INSURANCE PLAN
Plan identification number	512

DEAN HEALTH SYSTEMS, INC. GROUP LIFE INSURANCE PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Life insurance Death benefits (include travel accident but not life insurance) Other welfare benefit cover

401k Sponsoring company profile

DEAN HEALTH SYSTEMS, INC. has sponsored the creation of one or more 401k plans.

Company Name: DEAN HEALTH SYSTEMS, INC.

Employer identification number (EIN): 391128616

NAIC Classification: 621111
NAIC Description: Offices of Physicians (except Mental Health Specialists)

Form 5500 Filing Information

Submission information for form 5500 for 401k plan DEAN HEALTH SYSTEMS, INC. GROUP LIFE INSURANCE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
512 2014-01-01 STEVEN CALDWELL
512 2014-01-01 STEVEN CALDWELL
512 2013-01-01 STEVEN CALDWELL
512 2012-01-01 STEVEN CALDWELL
512 2011-01-01 STEVEN CALDWELL
512 2009-01-01 STEVEN R CALDWELL STEVEN R CALDWELL 2010-07-29

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
512	2014-01-01	STEVEN CALDWELL
512	2014-01-01	STEVEN CALDWELL
512	2013-01-01	STEVEN CALDWELL
512	2012-01-01	STEVEN CALDWELL
512	2011-01-01	STEVEN CALDWELL
512	2009-01-01	STEVEN R CALDWELL	STEVEN R CALDWELL	2010-07-29

Plan Statistics for DEAN HEALTH SYSTEMS, INC. GROUP LIFE INSURANCE PLAN

401k plan membership statisitcs for DEAN HEALTH SYSTEMS, INC. GROUP LIFE INSURANCE PLAN

Measure Date Value
2014: DEAN HEALTH SYSTEMS, INC. GROUP LIFE INSURANCE PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 3,764
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 3,802
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 17
Total of all active and inactive participants 2014-01-01 3,819
Total participants 2014-01-01 0
2013: DEAN HEALTH SYSTEMS, INC. GROUP LIFE INSURANCE PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 3,681
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 3,716
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 3,716
2012: DEAN HEALTH SYSTEMS, INC. GROUP LIFE INSURANCE PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 3,669
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 3,682
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 3,682
2011: DEAN HEALTH SYSTEMS, INC. GROUP LIFE INSURANCE PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 3,575
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 3,669
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 3,669
2009: DEAN HEALTH SYSTEMS, INC. GROUP LIFE INSURANCE PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 3,525
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 3,414
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 3,414

Measure	Date	Value
2014: DEAN HEALTH SYSTEMS, INC. GROUP LIFE INSURANCE PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	3,764
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	3,802
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	17
Total of all active and inactive participants	2014-01-01	3,819
Total participants	2014-01-01	0
2013: DEAN HEALTH SYSTEMS, INC. GROUP LIFE INSURANCE PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	3,681
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	3,716
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	3,716
2012: DEAN HEALTH SYSTEMS, INC. GROUP LIFE INSURANCE PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	3,669
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	3,682
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	3,682
2011: DEAN HEALTH SYSTEMS, INC. GROUP LIFE INSURANCE PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	3,575
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	3,669
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	3,669
2009: DEAN HEALTH SYSTEMS, INC. GROUP LIFE INSURANCE PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	3,525
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	3,414
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	3,414

Form 5500 Responses for DEAN HEALTH SYSTEMS, INC. GROUP LIFE INSURANCE PLAN

2014: DEAN HEALTH SYSTEMS, INC. GROUP LIFE INSURANCE PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Mulitple 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: DEAN HEALTH SYSTEMS, INC. GROUP LIFE INSURANCE PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Mulitple 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 – Insurance	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2012: DEAN HEALTH SYSTEMS, INC. GROUP LIFE INSURANCE PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Mulitple 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 – Insurance	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2011: DEAN HEALTH SYSTEMS, INC. GROUP LIFE INSURANCE PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Mulitple 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 – Insurance	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2009: DEAN HEALTH SYSTEMS, INC. GROUP LIFE INSURANCE PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Mulitple 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 – Insurance	Yes
2009-01-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )

Policy contract number

676301G

Policy instance

Insurance contract or identification number	676301G
Number of Individuals Covered	3798
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $35,552
Total amount of fees paid to insurance company	USD $74,294
Are there contracts with allocated funds for individual policies?	No
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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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 Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Other welfare benefits provided	AD&D
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 Carrier	USD $1,185,081
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $17,776
Amount paid for insurance broker fees	34163
Additional information about fees paid to insurance broker	BONUS
Insurance broker organization code?	3
Insurance broker name	BPC CLIENT SERVICES

HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )

Policy contract number

676301G

Policy instance

Insurance contract or identification number	676301G
Number of Individuals Covered	3716
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $36,282
Total amount of fees paid to insurance company	USD $49,081
Are there contracts with allocated funds for individual policies?	No
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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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 Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Other welfare benefits provided	AD&D
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 Carrier	USD $1,290,641
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $33,300
Amount paid for insurance broker fees	38089
Additional information about fees paid to insurance broker	BONUS
Insurance broker organization code?	3
Insurance broker name	LOCKTON INSURANCE BROKERS LLC

HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )

Policy contract number

676301G

Policy instance

Insurance contract or identification number	676301G
Number of Individuals Covered	3682
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $34,472
Total amount of fees paid to insurance company	USD $44,683
Are there contracts with allocated funds for individual policies?	No
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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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 Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Other welfare benefits provided	AD&D
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 Carrier	USD $1,070,820
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $34,472
Amount paid for insurance broker fees	32043
Additional information about fees paid to insurance broker	BONUS
Insurance broker organization code?	3
Insurance broker name	BPC CLIENT SERVICES

RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 )

Policy contract number

29035-1

Policy instance

Insurance contract or identification number	29035-1
Number of Individuals Covered	3669
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $33,597
Total amount of fees paid to insurance company	USD $19,038
Are there contracts with allocated funds for individual policies?	No
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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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 Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Other welfare benefits provided	AD&D
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 Carrier	USD $1,119,890
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 )

Policy contract number

29035-1

Policy instance

Insurance contract or identification number	29035-1
Number of Individuals Covered	3575
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $31,380
Total amount of fees paid to insurance company	USD $17,782
Are there contracts with allocated funds for individual policies?	No
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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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 Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Other welfare benefits provided	AD&D
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 Carrier	USD $1,046,020
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

Potentially related plans

DEAN HEALTH PLAN [EIN = 390854841]

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Company Name:	DEAN HEALTH SYSTEMS, INC.
Employer identification number (EIN):	391128616
NAIC Classification:	621111
NAIC Description:	Offices of Physicians (except Mental Health Specialists)