401k Plan data: ALL CHILDREN'S HEALTH SYSTEM SHORT TERM DISABILITY PLAN plan

ALL CHILDREN'S HEALTH SYSTEM SHORT TERM DISABILITY PLAN 401k Plan overview

Plan Name	ALL CHILDREN'S HEALTH SYSTEM SHORT TERM DISABILITY PLAN
Plan identification number	509

ALL CHILDREN'S HEALTH SYSTEM SHORT TERM DISABILITY PLAN Benefits

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

ALL CHILDRENS HEALTH SYSTEM, INC. has sponsored the creation of one or more 401k plans.

Company Name: ALL CHILDRENS HEALTH SYSTEM, INC.

Employer identification number (EIN): 592481740

NAIC Classification: 622000
NAIC Description: Hospitals

Form 5500 Filing Information

Submission information for form 5500 for 401k plan ALL CHILDREN'S HEALTH SYSTEM SHORT TERM DISABILITY PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
509 2017-01-01 JIM SCHMIDT JIM SCHMIDT 2018-09-26
509 2016-01-01 CHRISTOPHER WHITBY CHRISTOPHER WHITBY 2017-10-13
509 2015-01-01 DOUGLAS MYERS DOUGLAS MYERS 2016-10-13
509 2014-01-01 CLAYTON SPRIET CLAYTON SPRIET 2015-10-13
509 2013-01-01 NANCY TEMPLIN NANCY TEMPLIN 2014-10-07
509 2012-01-01 NANCY TEMPLIN NANCY TEMPLIN 2013-10-15
509 2011-04-01 NANCY TEMPLIN NANCY TEMPLIN 2012-10-17

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
509	2017-01-01	JIM SCHMIDT	JIM SCHMIDT	2018-09-26
509	2016-01-01	CHRISTOPHER WHITBY	CHRISTOPHER WHITBY	2017-10-13
509	2015-01-01	DOUGLAS MYERS	DOUGLAS MYERS	2016-10-13
509	2014-01-01	CLAYTON SPRIET	CLAYTON SPRIET	2015-10-13
509	2013-01-01	NANCY TEMPLIN	NANCY TEMPLIN	2014-10-07
509	2012-01-01	NANCY TEMPLIN	NANCY TEMPLIN	2013-10-15
509	2011-04-01	NANCY TEMPLIN	NANCY TEMPLIN	2012-10-17

Plan Statistics for ALL CHILDREN'S HEALTH SYSTEM SHORT TERM DISABILITY PLAN

401k plan membership statisitcs for ALL CHILDREN'S HEALTH SYSTEM SHORT TERM DISABILITY PLAN

Measure Date Value
2017: ALL CHILDREN'S HEALTH SYSTEM SHORT TERM DISABILITY PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 2,491
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 2,467
Total of all active and inactive participants 2017-01-01 2,467
Total participants 2017-01-01 2,467
2016: ALL CHILDREN'S HEALTH SYSTEM SHORT TERM DISABILITY PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 2,491
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 2,491
Total of all active and inactive participants 2016-01-01 2,491
Total participants 2016-01-01 2,491
2015: ALL CHILDREN'S HEALTH SYSTEM SHORT TERM DISABILITY PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 2,473
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 2,491
Total of all active and inactive participants 2015-01-01 2,491
Total participants 2015-01-01 2,491
2014: ALL CHILDREN'S HEALTH SYSTEM SHORT TERM DISABILITY PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 2,400
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 2,473
Total of all active and inactive participants 2014-01-01 2,473
Total participants 2014-01-01 2,473
2013: ALL CHILDREN'S HEALTH SYSTEM SHORT TERM DISABILITY PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 2,344
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 2,400
Total of all active and inactive participants 2013-01-01 2,400
Total participants 2013-01-01 2,400
2012: ALL CHILDREN'S HEALTH SYSTEM SHORT TERM DISABILITY PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 2,171
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 2,344
Total of all active and inactive participants 2012-01-01 2,344
2011: ALL CHILDREN'S HEALTH SYSTEM SHORT TERM DISABILITY PLAN 2011 401k membership
Total participants, beginning-of-year 2011-04-01 0
Total number of active participants reported on line 7a of the Form 5500 2011-04-01 2,171
Total of all active and inactive participants 2011-04-01 2,171

Measure	Date	Value
2017: ALL CHILDREN'S HEALTH SYSTEM SHORT TERM DISABILITY PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	2,491
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	2,467
Total of all active and inactive participants	2017-01-01	2,467
Total participants	2017-01-01	2,467
2016: ALL CHILDREN'S HEALTH SYSTEM SHORT TERM DISABILITY PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	2,491
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	2,491
Total of all active and inactive participants	2016-01-01	2,491
Total participants	2016-01-01	2,491
2015: ALL CHILDREN'S HEALTH SYSTEM SHORT TERM DISABILITY PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	2,473
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	2,491
Total of all active and inactive participants	2015-01-01	2,491
Total participants	2015-01-01	2,491
2014: ALL CHILDREN'S HEALTH SYSTEM SHORT TERM DISABILITY PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	2,400
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	2,473
Total of all active and inactive participants	2014-01-01	2,473
Total participants	2014-01-01	2,473
2013: ALL CHILDREN'S HEALTH SYSTEM SHORT TERM DISABILITY PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	2,344
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	2,400
Total of all active and inactive participants	2013-01-01	2,400
Total participants	2013-01-01	2,400
2012: ALL CHILDREN'S HEALTH SYSTEM SHORT TERM DISABILITY PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	2,171
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	2,344
Total of all active and inactive participants	2012-01-01	2,344
2011: ALL CHILDREN'S HEALTH SYSTEM SHORT TERM DISABILITY PLAN 2011 401k membership
Total participants, beginning-of-year	2011-04-01	0
Total number of active participants reported on line 7a of the Form 5500	2011-04-01	2,171
Total of all active and inactive participants	2011-04-01	2,171

Form 5500 Responses for ALL CHILDREN'S HEALTH SYSTEM SHORT TERM DISABILITY PLAN

2017: ALL CHILDREN'S HEALTH SYSTEM SHORT TERM DISABILITY PLAN 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	Submission has been amended	No
2017-01-01	This submission is the final filing	No
2017-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2017-01-01	Plan is a collectively bargained plan	No
2017-01-01	Plan funding arrangement – Insurance	Yes
2017-01-01	Plan benefit arrangement – Insurance	Yes
2016: ALL CHILDREN'S HEALTH SYSTEM SHORT TERM DISABILITY 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 – Insurance	Yes
2016-01-01	Plan benefit arrangement – Insurance	Yes
2015: ALL CHILDREN'S HEALTH SYSTEM SHORT 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	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 – Insurance	Yes
2015-01-01	Plan benefit arrangement – Insurance	Yes
2014: ALL CHILDREN'S HEALTH SYSTEM SHORT 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: ALL CHILDREN'S HEALTH SYSTEM SHORT TERM DISABILITY 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 benefit arrangement – Insurance	Yes
2012: ALL CHILDREN'S HEALTH SYSTEM SHORT TERM DISABILITY PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Plan funding arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2011: ALL CHILDREN'S HEALTH SYSTEM SHORT TERM DISABILITY PLAN 2011 form 5500 responses
2011-04-01	Type of plan entity	Single employer plan
2011-04-01	First time form 5500 has been submitted	Yes
2011-04-01	This return/report is a short plan year return/report (less than 12 months)	Yes
2011-04-01	Plan funding arrangement – Insurance	Yes
2011-04-01	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	395174G
Policy instance	1
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number	395174G
Policy instance	1
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number	395174G
Policy instance	1
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number	395174G
Policy instance	1
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number	395174GRH
Policy instance	1
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number	395174GRH
Policy instance	1

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Company Name:	ALL CHILDRENS HEALTH SYSTEM, INC.
Employer identification number (EIN):	592481740
NAIC Classification:	622000
NAIC Description:	Hospitals