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DIVINE SAVIOR HEALTHCARE INC SALARY SAVINGS 401K PLAN 401k Plan overview

Plan NameDIVINE SAVIOR HEALTHCARE INC SALARY SAVINGS 401K PLAN
Plan identification number 008

DIVINE SAVIOR HEALTHCARE INC SALARY SAVINGS 401K PLAN Benefits

401k Plan TypeDefined Contribution Pension
Plan Features/Benefits
  • Profit-sharing
  • ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
  • Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
  • Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
  • Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
  • Plan provides for automatic enrollment in plan that has employee contributions deducted from payroll.
  • Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
  • Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.

401k Sponsoring company profile

ASPIRUS, INC. has sponsored the creation of one or more 401k plans.

Company Name:ASPIRUS, INC.
Employer identification number (EIN):391328331
NAIC Classification:622000
NAIC Description: Hospitals

Form 5500 Filing Information

Submission information for form 5500 for 401k plan DIVINE SAVIOR HEALTHCARE INC SALARY SAVINGS 401K PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0082021-01-01

Plan Statistics for DIVINE SAVIOR HEALTHCARE INC SALARY SAVINGS 401K PLAN

401k plan membership statisitcs for DIVINE SAVIOR HEALTHCARE INC SALARY SAVINGS 401K PLAN

Measure Date Value
2021: DIVINE SAVIOR HEALTHCARE INC SALARY SAVINGS 401K PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-011,033
Total number of active participants reported on line 7a of the Form 55002021-01-010
Number of retired or separated participants receiving benefits2021-01-010
Number of other retired or separated participants entitled to future benefits2021-01-010
Total of all active and inactive participants2021-01-010
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2021-01-010
Total participants2021-01-010
Number of participants with account balances2021-01-010
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2021-01-010

Financial Data on DIVINE SAVIOR HEALTHCARE INC SALARY SAVINGS 401K PLAN

Measure Date Value
2021 : DIVINE SAVIOR HEALTHCARE INC SALARY SAVINGS 401K PLAN 2021 401k financial data
Total unrealized appreciation/depreciation of assets2021-02-23$0
Total transfer of assets from this plan2021-02-23$68,075,030
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-02-23$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-02-23$0
Total income from all sources (including contributions)2021-02-23$3,105,987
Total loss/gain on sale of assets2021-02-23$0
Total of all expenses incurred2021-02-23$5,295,688
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-02-23$5,282,741
Expenses. Certain deemed distributions of participant loans2021-02-23$1,159
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-02-23$0
Value of total assets at end of year2021-02-23$0
Value of total assets at beginning of year2021-02-23$70,264,731
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-02-23$11,788
Total interest from all sources2021-02-23$174,600
Total dividends received (eg from common stock, registered investment company shares)2021-02-23$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2021-02-23Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan2021-02-23$0
Was this plan covered by a fidelity bond2021-02-23Yes
Value of fidelity bond cover2021-02-23$500,000
If this is an individual account plan, was there a blackout period2021-02-23Yes
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2021-02-23$0
Were there any nonexempt tranactions with any party-in-interest2021-02-23No
Participant contributions at end of year2021-02-23$0
Participant contributions at beginning of year2021-02-23$119,757
Participant contributions at end of year2021-02-23$0
Participant contributions at beginning of year2021-02-23$98,078
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2021-02-23No
Value of net income/loss2021-02-23$-2,189,701
Value of net assets at end of year (total assets less liabilities)2021-02-23$0
Value of net assets at beginning of year (total assets less liabilities)2021-02-23$70,264,731
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2021-02-23No
Were any loans by the plan or fixed income obligations due to the plan in default2021-02-23No
Were any leases to which the plan was party in default or uncollectible2021-02-23No
Value of interest in registered invesment companies (eg mutual funds) at end of year2021-02-23$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2021-02-23$67,124,312
Interest on participant loans2021-02-23$547
Interest earned on other investments2021-02-23$174,053
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2021-02-23$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2021-02-23$2,870,331
Net investment gain/loss from pooled separate accounts2021-02-23$2,931,387
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2021-02-23No
Was there a failure to transmit to the plan any participant contributions2021-02-23No
Has the plan failed to provide any benefit when due under the plan2021-02-23No
Employer contributions (assets) at end of year2021-02-23$0
Employer contributions (assets) at beginning of year2021-02-23$52,253
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2021-02-23$5,282,741
Contract administrator fees2021-02-23$11,788
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32021-02-23Yes
Did the plan have assets held for investment2021-02-23No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2021-02-23No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2021-02-23Yes
Opinion of an independent qualified public accountant for this plan2021-02-23Unqualified
Accountancy firm name2021-02-23WIPFLI LLP
Accountancy firm EIN2021-02-23390758449

Form 5500 Responses for DIVINE SAVIOR HEALTHCARE INC SALARY SAVINGS 401K PLAN

2021: DIVINE SAVIOR HEALTHCARE INC SALARY SAVINGS 401K PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Submission has been amendedNo
2021-01-01This submission is the final filingYes
2021-01-01This return/report is a short plan year return/report (less than 12 months)Yes
2021-01-01Plan is a collectively bargained planNo
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan funding arrangement – TrustYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )
Policy contract numberPHR912
Policy instance 1
Insurance contract or identification numberPHR912
Number of Individuals Covered0
Insurance policy start date2021-01-01
Insurance policy end date2021-02-23
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $8,346
Are there contracts with allocated funds for individual policies?0
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees8346
Additional information about fees paid to insurance brokerTPA PARTNERSHIP
Insurance broker organization code?3

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