401k Plan data: EVOLENT HEALTH, LLC 401(K) PLAN plan

EVOLENT HEALTH, LLC 401(K) PLAN 401k Plan overview

Plan Name	EVOLENT HEALTH, LLC 401(K) PLAN
Plan identification number	001

EVOLENT HEALTH, LLC 401(K) PLAN Benefits

401k Plan Type

Defined 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.
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.
Plan sponsor(s) is (are) a member(s) of a controlled group (Code sections 414(b), (c), or (m)).

401k Sponsoring company profile

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

Company Name: EVOLENT HEALTH LLC

Employer identification number (EIN): 453084136

NAIC Classification: 541700

Form 5500 Filing Information

Submission information for form 5500 for 401k plan EVOLENT HEALTH, LLC 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2016-01-01 DAVE THORNTON
001 2016-01-01 DAVID THORNTON 2020-02-13
001 2015-01-01 DAVID THORNTON
001 2014-01-01 DAVID THORNTON
001 2014-01-01 DAVID THORNTON
001 2014-01-01 DAVID THORNTON
001 2013-01-01 DAVID THORNTON
001 2012-02-01 BETTYANN LAY 2013-08-27 BETTYANN LAY 2013-10-02

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
001	2016-01-01	DAVE THORNTON
001	2016-01-01			DAVID THORNTON	2020-02-13
001	2015-01-01	DAVID THORNTON
001	2014-01-01	DAVID THORNTON
001	2014-01-01	DAVID THORNTON
001	2014-01-01	DAVID THORNTON
001	2013-01-01	DAVID THORNTON
001	2012-02-01	BETTYANN LAY	2013-08-27	BETTYANN LAY	2013-10-02

Plan Statistics for EVOLENT HEALTH, LLC 401(K) PLAN

401k plan membership statisitcs for EVOLENT HEALTH, LLC 401(K) PLAN

Measure Date Value
2016: EVOLENT HEALTH, LLC 401(K) PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 1,115
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 1,396
Number of retired or separated participants receiving benefits 2016-01-01 0
Number of other retired or separated participants entitled to future benefits 2016-01-01 136
Total of all active and inactive participants 2016-01-01 1,532
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
Total participants 2016-01-01 1,532
Number of participants with account balances 2016-01-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 0
2015: EVOLENT HEALTH, LLC 401(K) PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 810
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 948
Number of retired or separated participants receiving benefits 2015-01-01 0
Number of other retired or separated participants entitled to future benefits 2015-01-01 167
Total of all active and inactive participants 2015-01-01 1,115
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 1,115
Number of participants with account balances 2015-01-01 959
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 0
2014: EVOLENT HEALTH, LLC 401(K) PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 551
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 733
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 77
Total of all active and inactive participants 2014-01-01 810
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 0
Total participants 2014-01-01 810
Number of participants with account balances 2014-01-01 683
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 0
2013: EVOLENT HEALTH, LLC 401(K) PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 157
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 463
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 17
Total of all active and inactive participants 2013-01-01 480
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 0
Total participants 2013-01-01 480
Number of participants with account balances 2013-01-01 337
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 0

Measure	Date	Value
2016: EVOLENT HEALTH, LLC 401(K) PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	1,115
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	1,396
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	136
Total of all active and inactive participants	2016-01-01	1,532
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	1,532
Number of participants with account balances	2016-01-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	0
2015: EVOLENT HEALTH, LLC 401(K) PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	810
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	948
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	167
Total of all active and inactive participants	2015-01-01	1,115
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	1,115
Number of participants with account balances	2015-01-01	959
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	0
2014: EVOLENT HEALTH, LLC 401(K) PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	551
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	733
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	77
Total of all active and inactive participants	2014-01-01	810
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	810
Number of participants with account balances	2014-01-01	683
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	0
2013: EVOLENT HEALTH, LLC 401(K) PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	157
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	463
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	17
Total of all active and inactive participants	2013-01-01	480
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	480
Number of participants with account balances	2013-01-01	337
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	0

Financial Data on EVOLENT HEALTH, LLC 401(K) PLAN

Measure	Date	Value
2016 : EVOLENT HEALTH, LLC 401(K) PLAN 2016 401k financial data
Total unrealized appreciation/depreciation of assets	2016-12-31	$0
Total transfer of assets from this plan	2016-12-31	$42,351,942
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-12-31	$42,351,942
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-12-31	$0
Total income from all sources (including contributions)	2016-12-31	$19,440,673
Total loss/gain on sale of assets	2016-12-31	$0
Total of all expenses incurred	2016-12-31	$2,816,139
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-12-31	$2,672,661
Value of total corrective distributions	2016-12-31	$1,607
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-12-31	$16,164,716
Value of total assets at end of year	2016-12-31	$42,351,942
Value of total assets at beginning of year	2016-12-31	$25,727,408
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-12-31	$141,871
Total interest from all sources	2016-12-31	$18,859
Total dividends received (eg from common stock, registered investment company shares)	2016-12-31	$760,068
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2016-12-31	Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan	2016-12-31	$0
Total dividends received from registered investment company shares (eg mutual funds)	2016-12-31	$760,068
Was this plan covered by a fidelity bond	2016-12-31	Yes
Value of fidelity bond cover	2016-12-31	$500,000
If this is an individual account plan, was there a blackout period	2016-12-31	Yes
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2016-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2016-12-31	No
Contributions received from participants	2016-12-31	$7,775,541
Participant contributions at end of year	2016-12-31	$776,443
Participant contributions at beginning of year	2016-12-31	$379,357
Income. Received or receivable in cash from other sources (including rollovers)	2016-12-31	$4,556,382
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2016-12-31	$42,351,942
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-12-31	No
Value of net income/loss	2016-12-31	$16,624,534
Value of net assets at end of year (total assets less liabilities)	2016-12-31	$0
Value of net assets at beginning of year (total assets less liabilities)	2016-12-31	$25,727,408
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2016-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2016-12-31	No
Were any leases to which the plan was party in default or uncollectible	2016-12-31	No
Investment advisory and management fees	2016-12-31	$84,548
Value of interest in registered invesment companies (eg mutual funds) at end of year	2016-12-31	$40,954,397
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2016-12-31	$24,658,212
Interest on participant loans	2016-12-31	$18,859
Income. Interest from loans (other than to participants)	2016-12-31	$0
Value of interest in common/collective trusts at end of year	2016-12-31	$621,102
Value of interest in common/collective trusts at beginning of year	2016-12-31	$357,315
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2016-12-31	$2,486,530
Net investment gain or loss from common/collective trusts	2016-12-31	$10,500
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2016-12-31	No
Was there a failure to transmit to the plan any participant contributions	2016-12-31	No
Has the plan failed to provide any benefit when due under the plan	2016-12-31	No
Contributions received in cash from employer	2016-12-31	$3,832,793
Employer contributions (assets) at end of year	2016-12-31	$0
Employer contributions (assets) at beginning of year	2016-12-31	$332,524
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2016-12-31	$2,672,661
Contract administrator fees	2016-12-31	$57,323
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2016-12-31	Yes
Did the plan have assets held for investment	2016-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2016-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2016-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2016-12-31	Disclaimer
Accountancy firm name	2016-12-31	ARONSON LLC
Accountancy firm EIN	2016-12-31	371611326
2015 : EVOLENT HEALTH, LLC 401(K) PLAN 2015 401k financial data
Total unrealized appreciation/depreciation of assets	2015-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-12-31	$0
Total income from all sources (including contributions)	2015-12-31	$12,065,573
Total loss/gain on sale of assets	2015-12-31	$0
Total of all expenses incurred	2015-12-31	$1,110,009
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-12-31	$1,043,434
Value of total corrective distributions	2015-12-31	$4,487
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-12-31	$12,586,423
Value of total assets at end of year	2015-12-31	$25,727,408
Value of total assets at beginning of year	2015-12-31	$14,771,844
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-12-31	$62,088
Total interest from all sources	2015-12-31	$8,529
Total dividends received (eg from common stock, registered investment company shares)	2015-12-31	$480,841
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2015-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2015-12-31	$480,841
Was this plan covered by a fidelity bond	2015-12-31	Yes
Value of fidelity bond cover	2015-12-31	$500,000
If this is an individual account plan, was there a blackout period	2015-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2015-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2015-12-31	No
Contributions received from participants	2015-12-31	$6,727,078
Participant contributions at end of year	2015-12-31	$379,357
Participant contributions at beginning of year	2015-12-31	$186,968
Income. Received or receivable in cash from other sources (including rollovers)	2015-12-31	$2,277,297
Administrative expenses (other) incurred	2015-12-31	$35
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-12-31	No
Value of net income/loss	2015-12-31	$10,955,564
Value of net assets at end of year (total assets less liabilities)	2015-12-31	$25,727,408
Value of net assets at beginning of year (total assets less liabilities)	2015-12-31	$14,771,844
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2015-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2015-12-31	No
Were any leases to which the plan was party in default or uncollectible	2015-12-31	No
Investment advisory and management fees	2015-12-31	$51,107
Value of interest in registered invesment companies (eg mutual funds) at end of year	2015-12-31	$24,658,212
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2015-12-31	$14,160,281
Interest on participant loans	2015-12-31	$8,529
Income. Interest from loans (other than to participants)	2015-12-31	$0
Value of interest in common/collective trusts at end of year	2015-12-31	$357,315
Value of interest in common/collective trusts at beginning of year	2015-12-31	$192,219
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2015-12-31	$-1,016,669
Net investment gain or loss from common/collective trusts	2015-12-31	$6,449
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2015-12-31	No
Was there a failure to transmit to the plan any participant contributions	2015-12-31	No
Has the plan failed to provide any benefit when due under the plan	2015-12-31	No
Contributions received in cash from employer	2015-12-31	$3,582,048
Employer contributions (assets) at end of year	2015-12-31	$332,524
Employer contributions (assets) at beginning of year	2015-12-31	$232,376
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2015-12-31	$1,043,434
Contract administrator fees	2015-12-31	$10,946
Did the plan have assets held for investment	2015-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2015-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2015-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2015-12-31	Disclaimer
Accountancy firm name	2015-12-31	ARONSON LLC
Accountancy firm EIN	2015-12-31	371611326
2014 : EVOLENT HEALTH, LLC 401(K) PLAN 2014 401k financial data
Total unrealized appreciation/depreciation of assets	2014-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-12-31	$0
Total income from all sources (including contributions)	2014-12-31	$9,783,251
Total loss/gain on sale of assets	2014-12-31	$0
Total of all expenses incurred	2014-12-31	$750,902
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-12-31	$708,616
Value of total corrective distributions	2014-12-31	$6,261
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-12-31	$9,063,467
Value of total assets at end of year	2014-12-31	$14,771,844
Value of total assets at beginning of year	2014-12-31	$5,739,495
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-12-31	$36,025
Total interest from all sources	2014-12-31	$4,630
Total dividends received (eg from common stock, registered investment company shares)	2014-12-31	$272,043
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2014-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2014-12-31	$272,043
Was this plan covered by a fidelity bond	2014-12-31	Yes
Value of fidelity bond cover	2014-12-31	$150,000
If this is an individual account plan, was there a blackout period	2014-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2014-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2014-12-31	No
Contributions received from participants	2014-12-31	$4,615,347
Participant contributions at end of year	2014-12-31	$186,968
Participant contributions at beginning of year	2014-12-31	$19,850
Participant contributions at beginning of year	2014-12-31	$136,582
Income. Received or receivable in cash from other sources (including rollovers)	2014-12-31	$1,936,847
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-12-31	No
Value of net income/loss	2014-12-31	$9,032,349
Value of net assets at end of year (total assets less liabilities)	2014-12-31	$14,771,844
Value of net assets at beginning of year (total assets less liabilities)	2014-12-31	$5,739,495
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2014-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2014-12-31	No
Were any leases to which the plan was party in default or uncollectible	2014-12-31	No
Investment advisory and management fees	2014-12-31	$31,461
Value of interest in registered invesment companies (eg mutual funds) at end of year	2014-12-31	$14,160,281
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2014-12-31	$5,260,531
Interest on participant loans	2014-12-31	$4,630
Value of interest in common/collective trusts at end of year	2014-12-31	$192,219
Value of interest in common/collective trusts at beginning of year	2014-12-31	$93,263
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2014-12-31	$193
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2014-12-31	$193
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2014-12-31	$439,769
Net investment gain or loss from common/collective trusts	2014-12-31	$3,342
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2014-12-31	No
Was there a failure to transmit to the plan any participant contributions	2014-12-31	No
Has the plan failed to provide any benefit when due under the plan	2014-12-31	No
Contributions received in cash from employer	2014-12-31	$2,511,273
Employer contributions (assets) at end of year	2014-12-31	$232,376
Employer contributions (assets) at beginning of year	2014-12-31	$229,076
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2014-12-31	$708,616
Contract administrator fees	2014-12-31	$4,564
Did the plan have assets held for investment	2014-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2014-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2014-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2014-12-31	Disclaimer
Accountancy firm name	2014-12-31	ARONSON LLC
Accountancy firm EIN	2014-12-31	371611326
2013 : EVOLENT HEALTH, LLC 401(K) PLAN 2013 401k financial data
Total unrealized appreciation/depreciation of assets	2013-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-12-31	$0
Total income from all sources (including contributions)	2013-12-31	$4,777,270
Total loss/gain on sale of assets	2013-12-31	$0
Total of all expenses incurred	2013-12-31	$93,538
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2013-12-31	$92,768
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2013-12-31	$4,311,647
Value of total assets at end of year	2013-12-31	$5,739,495
Value of total assets at beginning of year	2013-12-31	$1,055,763
Total of administrative expenses incurred including professional, contract, advisory and management fees	2013-12-31	$770
Total interest from all sources	2013-12-31	$1,019
Total dividends received (eg from common stock, registered investment company shares)	2013-12-31	$69,736
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2013-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2013-12-31	$69,736
Was this plan covered by a fidelity bond	2013-12-31	Yes
Value of fidelity bond cover	2013-12-31	$25,000
If this is an individual account plan, was there a blackout period	2013-12-31	Yes
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2013-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2013-12-31	No
Contributions received from participants	2013-12-31	$2,100,434
Participant contributions at end of year	2013-12-31	$19,850
Participant contributions at beginning of year	2013-12-31	$8,398
Participant contributions at end of year	2013-12-31	$136,582
Participant contributions at beginning of year	2013-12-31	$85,592
Income. Received or receivable in cash from other sources (including rollovers)	2013-12-31	$1,048,488
Other income not declared elsewhere	2013-12-31	$-2,569
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2013-12-31	No
Value of net income/loss	2013-12-31	$4,683,732
Value of net assets at end of year (total assets less liabilities)	2013-12-31	$5,739,495
Value of net assets at beginning of year (total assets less liabilities)	2013-12-31	$1,055,763
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2013-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2013-12-31	No
Were any leases to which the plan was party in default or uncollectible	2013-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2013-12-31	$5,260,531
Value of interest in pooled separate accounts at beginning of year	2013-12-31	$810,467
Interest on participant loans	2013-12-31	$826
Value of interest in common/collective trusts at end of year	2013-12-31	$93,263
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2013-12-31	$193
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2013-12-31	$193
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2013-12-31	$151,306
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2013-12-31	$-12,549
Net investment gain/loss from pooled separate accounts	2013-12-31	$409,930
Net investment gain or loss from common/collective trusts	2013-12-31	$56
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2013-12-31	No
Was there a failure to transmit to the plan any participant contributions	2013-12-31	No
Has the plan failed to provide any benefit when due under the plan	2013-12-31	No
Contributions received in cash from employer	2013-12-31	$1,162,725
Employer contributions (assets) at end of year	2013-12-31	$229,076
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2013-12-31	$92,768
Contract administrator fees	2013-12-31	$770
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2013-12-31	Yes
Did the plan have assets held for investment	2013-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2013-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2013-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2013-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2013-12-31	Disclaimer
Accountancy firm name	2013-12-31	STURGILL, RIZZO, MCLANIGAN LLC
Accountancy firm EIN	2013-12-31	030494806

Form 5500 Responses for EVOLENT HEALTH, LLC 401(K) PLAN

2016: EVOLENT HEALTH, LLC 401(K) PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
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 – Trust	Yes
2016-01-01	Plan benefit arrangement - Trust	Yes
2015: EVOLENT HEALTH, LLC 401(K) PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
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 – Trust	Yes
2015-01-01	Plan benefit arrangement - Trust	Yes
2014: EVOLENT HEALTH, LLC 401(K) PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Submission has been amended	Yes
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 – Trust	Yes
2014-01-01	Plan benefit arrangement - Trust	Yes
2013: EVOLENT HEALTH, LLC 401(K) 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 – Insurance	Yes
2013-01-01	Plan funding arrangement – Trust	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2013-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )

Policy contract number

617956

Policy instance

Insurance contract or identification number	617956
Number of Individuals Covered	0
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $17,947
Total amount of fees paid to insurance company	USD $481
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	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
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
Commission paid to Insurance Broker	USD $17,947
Amount paid for insurance broker fees	0
Insurance broker organization code?	3
Additional information about fees paid to insurance broker	PRORATED INCENTIVE, NOT DEDUCTED FROM PLAN
Insurance broker name	FINANCIAL TELESIS INC

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Company Name:	EVOLENT HEALTH LLC
Employer identification number (EIN):	453084136
NAIC Classification:	541700