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QHR HEALTH, LLC CRITICAL ILLNESS PLAN 401k Plan overview

Plan NameQHR HEALTH, LLC CRITICAL ILLNESS PLAN
Plan identification number 504

QHR HEALTH, LLC CRITICAL ILLNESS PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Other welfare benefit cover

401k Sponsoring company profile

QUORUM HEALTH RESOURCES, LLC has sponsored the creation of one or more 401k plans.

Company Name:QUORUM HEALTH RESOURCES, LLC
Employer identification number (EIN):621742954
NAIC Classification:541990
NAIC Description:All Other Professional, Scientific, and Technical Services

Form 5500 Filing Information

Submission information for form 5500 for 401k plan QHR HEALTH, LLC CRITICAL ILLNESS PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5042021-06-01

Plan Statistics for QHR HEALTH, LLC CRITICAL ILLNESS PLAN

401k plan membership statisitcs for QHR HEALTH, LLC CRITICAL ILLNESS PLAN

Measure Date Value
2021: QHR HEALTH, LLC CRITICAL ILLNESS PLAN 2021 401k membership
Total participants, beginning-of-year2021-06-01101
Total number of active participants reported on line 7a of the Form 55002021-06-01119
Number of retired or separated participants receiving benefits2021-06-010
Number of other retired or separated participants entitled to future benefits2021-06-010
Total of all active and inactive participants2021-06-01119

Form 5500 Responses for QHR HEALTH, LLC CRITICAL ILLNESS PLAN

2021: QHR HEALTH, LLC CRITICAL ILLNESS PLAN 2021 form 5500 responses
2021-06-01Type of plan entitySingle employer plan
2021-06-01First time form 5500 has been submittedYes
2021-06-01Submission has been amendedNo
2021-06-01This submission is the final filingNo
2021-06-01This return/report is a short plan year return/report (less than 12 months)No
2021-06-01Plan is a collectively bargained planNo
2021-06-01Plan funding arrangement – InsuranceYes
2021-06-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 )
Policy contract number56188
Policy instance 1
Insurance contract or identification number56188
Number of Individuals Covered66
Insurance policy start date2021-06-01
Insurance policy end date2022-05-31
Total amount of commissions paid to insurance brokerUSD $12,880
Total amount of fees paid to insurance companyUSD $740
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?No
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
Other welfare benefits providedCRITICAL ILLNESS
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 CarrierUSD $21,687
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $12,880
Insurance broker organization code?3
Amount paid for insurance broker fees740
Additional information about fees paid to insurance brokerSUPPLEMENTAL COMPENSATION

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