401k Plan data: OPTUM360 SHORT-TERM AND LONG-TERM DISABILITY PLAN plan

OPTUM360 SHORT-TERM AND LONG-TERM DISABILITY PLAN 401k Plan overview

Plan Name	OPTUM360 SHORT-TERM AND LONG-TERM DISABILITY PLAN
Plan identification number	503

OPTUM360 SHORT-TERM AND LONG-TERM DISABILITY PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Temporary disability (accident and sickness) Long-term disability cover

401k Sponsoring company profile

OPTUM360 SERVICES, INC. has sponsored the creation of one or more 401k plans.

Company Name: OPTUM360 SERVICES, INC.

Employer identification number (EIN): 463983926

NAIC Classification: 541600

Additional information about OPTUM360 SERVICES, INC.

Jurisdiction of Incorporation: Texas Secretary of State

Incorporation Date: 2013-12-06

Company Identification Number: 0801894727

Legal Registered Office Address: 1999 BRYAN ST STE 900

DALLAS
United States of America (USA)
75201

More information about OPTUM360 SERVICES, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan OPTUM360 SHORT-TERM AND LONG-TERM DISABILITY PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
503 2015-01-01 DAVID E. STRAUSS
503 2014-01-01 DAVID E. STRAUSS
503 2013-12-15 DAVID E. STRAUSS

Plan id#	Filing Submission Date	Name of Administrator
503	2015-01-01	DAVID E. STRAUSS
503	2014-01-01	DAVID E. STRAUSS
503	2013-12-15	DAVID E. STRAUSS

Plan Statistics for OPTUM360 SHORT-TERM AND LONG-TERM DISABILITY PLAN

401k plan membership statisitcs for OPTUM360 SHORT-TERM AND LONG-TERM DISABILITY PLAN

Measure Date Value
2015: OPTUM360 SHORT-TERM AND LONG-TERM DISABILITY PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 2,278
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 0
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 0
2014: OPTUM360 SHORT-TERM AND LONG-TERM DISABILITY PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 1,948
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 2,275
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 2,275
2013: OPTUM360 SHORT-TERM AND LONG-TERM DISABILITY PLAN 2013 401k membership
Total participants, beginning-of-year 2013-12-15 2,062
Total number of active participants reported on line 7a of the Form 5500 2013-12-15 2,062
Number of retired or separated participants receiving benefits 2013-12-15 0
Number of other retired or separated participants entitled to future benefits 2013-12-15 0
Total of all active and inactive participants 2013-12-15 2,062
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-12-15 0

Measure	Date	Value
2015: OPTUM360 SHORT-TERM AND LONG-TERM DISABILITY PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	2,278
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	0
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	0
2014: OPTUM360 SHORT-TERM AND LONG-TERM DISABILITY PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	1,948
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	2,275
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	2,275
2013: OPTUM360 SHORT-TERM AND LONG-TERM DISABILITY PLAN 2013 401k membership
Total participants, beginning-of-year	2013-12-15	2,062
Total number of active participants reported on line 7a of the Form 5500	2013-12-15	2,062
Number of retired or separated participants receiving benefits	2013-12-15	0
Number of other retired or separated participants entitled to future benefits	2013-12-15	0
Total of all active and inactive participants	2013-12-15	2,062
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-12-15	0

Form 5500 Responses for OPTUM360 SHORT-TERM AND LONG-TERM DISABILITY PLAN

2015: OPTUM360 SHORT-TERM AND LONG-TERM DISABILITY 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	Yes
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: OPTUM360 SHORT-TERM AND LONG-TERM DISABILITY PLAN 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: OPTUM360 SHORT-TERM AND LONG-TERM DISABILITY PLAN 2013 form 5500 responses
2013-12-15	Type of plan entity	Single employer plan
2013-12-15	First time form 5500 has been submitted	Yes
2013-12-15	Submission has been amended	No
2013-12-15	This submission is the final filing	No
2013-12-15	This return/report is a short plan year return/report (less than 12 months)	Yes
2013-12-15	Plan is a collectively bargained plan	No
2013-12-15	Plan funding arrangement – General assets of the sponsor	Yes
2013-12-15	Plan benefit arrangement – General assets of the sponsor	Yes

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Company Name:	OPTUM360 SERVICES, INC.
Employer identification number (EIN):	463983926
NAIC Classification:	541600

Jurisdiction of Incorporation:	Texas Secretary of State
Incorporation Date:	2013-12-06
Company Identification Number:	0801894727
Legal Registered Office Address:	1999 BRYAN ST STE 900 DALLAS United States of America (USA) 75201