401k Plan data: DELANO REGIONAL MEDICAL CENTER GROUP HEALTH PLAN plan

DELANO REGIONAL MEDICAL CENTER GROUP HEALTH PLAN 401k Plan overview

Plan Name	DELANO REGIONAL MEDICAL CENTER GROUP HEALTH PLAN
Plan identification number	501

DELANO REGIONAL MEDICAL CENTER GROUP HEALTH PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) Life insurance Dental Vision Prepaid legal Long-term disability cover Death benefits (include travel accident but not life insurance) Other welfare benefit cover

401k Sponsoring company profile

ADVENTIST HEALTH DELANO has sponsored the creation of one or more 401k plans.

Company Name: ADVENTIST HEALTH DELANO

Employer identification number (EIN): 770258013

NAIC Classification: 622000
NAIC Description: Hospitals

Form 5500 Filing Information

Submission information for form 5500 for 401k plan DELANO REGIONAL MEDICAL CENTER GROUP HEALTH PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2021-01-01
501 2021-01-01
501 2021-01-01 LISA DEININGER
501 2020-01-01
501 2019-05-01
501 2017-05-01 BAHRAM GHAFFARI
501 2016-05-01 BAHRAM GHAFFARI BAHRAM GHAFFARI 2018-01-31
501 2015-05-01 BAHRAM GHAFFARI
501 2014-05-01 BAHRAM GHAFFARI
501 2013-05-01 BAHRAM GHAFFARI
501 2012-05-01 BAHRAM GHAFFARI
501 2011-05-01 BAHRAM GHAFFARI
501 2009-05-01 BAHRAM GHAFFARI

Plan Statistics for DELANO REGIONAL MEDICAL CENTER GROUP HEALTH PLAN

401k plan membership statisitcs for DELANO REGIONAL MEDICAL CENTER GROUP HEALTH PLAN

Measure Date Value
2021: DELANO REGIONAL MEDICAL CENTER GROUP HEALTH PLAN 2021 401k membership
Total participants, beginning-of-year 2021-01-01 511
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 468
Number of retired or separated participants receiving benefits 2021-01-01 2
Number of other retired or separated participants entitled to future benefits 2021-01-01 17
Total of all active and inactive participants 2021-01-01 487
2020: DELANO REGIONAL MEDICAL CENTER GROUP HEALTH PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 526
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 457
Number of retired or separated participants receiving benefits 2020-01-01 1
Number of other retired or separated participants entitled to future benefits 2020-01-01 59
Total of all active and inactive participants 2020-01-01 517
2019: DELANO REGIONAL MEDICAL CENTER GROUP HEALTH PLAN 2019 401k membership
Total participants, beginning-of-year 2019-05-01 501
Total number of active participants reported on line 7a of the Form 5500 2019-05-01 0
Number of retired or separated participants receiving benefits 2019-05-01 0
Number of other retired or separated participants entitled to future benefits 2019-05-01 0
Total of all active and inactive participants 2019-05-01 0
2017: DELANO REGIONAL MEDICAL CENTER GROUP HEALTH PLAN 2017 401k membership
Total participants, beginning-of-year 2017-05-01 434
Total number of active participants reported on line 7a of the Form 5500 2017-05-01 515
Number of retired or separated participants receiving benefits 2017-05-01 4
Number of other retired or separated participants entitled to future benefits 2017-05-01 0
Total of all active and inactive participants 2017-05-01 519
2016: DELANO REGIONAL MEDICAL CENTER GROUP HEALTH PLAN 2016 401k membership
Total participants, beginning-of-year 2016-05-01 502
Total number of active participants reported on line 7a of the Form 5500 2016-05-01 431
Number of retired or separated participants receiving benefits 2016-05-01 3
Number of other retired or separated participants entitled to future benefits 2016-05-01 0
Total of all active and inactive participants 2016-05-01 434
2015: DELANO REGIONAL MEDICAL CENTER GROUP HEALTH PLAN 2015 401k membership
Total participants, beginning-of-year 2015-05-01 516
Total number of active participants reported on line 7a of the Form 5500 2015-05-01 502
Number of retired or separated participants receiving benefits 2015-05-01 0
Number of other retired or separated participants entitled to future benefits 2015-05-01 0
Total of all active and inactive participants 2015-05-01 502
2014: DELANO REGIONAL MEDICAL CENTER GROUP HEALTH PLAN 2014 401k membership
Total participants, beginning-of-year 2014-05-01 492
Total number of active participants reported on line 7a of the Form 5500 2014-05-01 516
Number of retired or separated participants receiving benefits 2014-05-01 0
Number of other retired or separated participants entitled to future benefits 2014-05-01 0
Total of all active and inactive participants 2014-05-01 516
2013: DELANO REGIONAL MEDICAL CENTER GROUP HEALTH PLAN 2013 401k membership
Total participants, beginning-of-year 2013-05-01 501
Total number of active participants reported on line 7a of the Form 5500 2013-05-01 488
Number of retired or separated participants receiving benefits 2013-05-01 4
Number of other retired or separated participants entitled to future benefits 2013-05-01 0
Total of all active and inactive participants 2013-05-01 492
2012: DELANO REGIONAL MEDICAL CENTER GROUP HEALTH PLAN 2012 401k membership
Total participants, beginning-of-year 2012-05-01 502
Total number of active participants reported on line 7a of the Form 5500 2012-05-01 501
Number of retired or separated participants receiving benefits 2012-05-01 0
Number of other retired or separated participants entitled to future benefits 2012-05-01 0
Total of all active and inactive participants 2012-05-01 501
2011: DELANO REGIONAL MEDICAL CENTER GROUP HEALTH PLAN 2011 401k membership
Total participants, beginning-of-year 2011-05-01 497
Total number of active participants reported on line 7a of the Form 5500 2011-05-01 501
Number of retired or separated participants receiving benefits 2011-05-01 1
Number of other retired or separated participants entitled to future benefits 2011-05-01 0
Total of all active and inactive participants 2011-05-01 502
2009: DELANO REGIONAL MEDICAL CENTER GROUP HEALTH PLAN 2009 401k membership
Total participants, beginning-of-year 2009-05-01 274
Total number of active participants reported on line 7a of the Form 5500 2009-05-01 459
Number of retired or separated participants receiving benefits 2009-05-01 16
Number of other retired or separated participants entitled to future benefits 2009-05-01 0
Total of all active and inactive participants 2009-05-01 475

Measure	Date	Value
2021: DELANO REGIONAL MEDICAL CENTER GROUP HEALTH PLAN 2021 401k membership
Total participants, beginning-of-year	2021-01-01	511
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	468
Number of retired or separated participants receiving benefits	2021-01-01	2
Number of other retired or separated participants entitled to future benefits	2021-01-01	17
Total of all active and inactive participants	2021-01-01	487
2020: DELANO REGIONAL MEDICAL CENTER GROUP HEALTH PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	526
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	457
Number of retired or separated participants receiving benefits	2020-01-01	1
Number of other retired or separated participants entitled to future benefits	2020-01-01	59
Total of all active and inactive participants	2020-01-01	517
2019: DELANO REGIONAL MEDICAL CENTER GROUP HEALTH PLAN 2019 401k membership
Total participants, beginning-of-year	2019-05-01	501
Total number of active participants reported on line 7a of the Form 5500	2019-05-01	0
Number of retired or separated participants receiving benefits	2019-05-01	0
Number of other retired or separated participants entitled to future benefits	2019-05-01	0
Total of all active and inactive participants	2019-05-01	0
2017: DELANO REGIONAL MEDICAL CENTER GROUP HEALTH PLAN 2017 401k membership
Total participants, beginning-of-year	2017-05-01	434
Total number of active participants reported on line 7a of the Form 5500	2017-05-01	515
Number of retired or separated participants receiving benefits	2017-05-01	4
Number of other retired or separated participants entitled to future benefits	2017-05-01	0
Total of all active and inactive participants	2017-05-01	519
2016: DELANO REGIONAL MEDICAL CENTER GROUP HEALTH PLAN 2016 401k membership
Total participants, beginning-of-year	2016-05-01	502
Total number of active participants reported on line 7a of the Form 5500	2016-05-01	431
Number of retired or separated participants receiving benefits	2016-05-01	3
Number of other retired or separated participants entitled to future benefits	2016-05-01	0
Total of all active and inactive participants	2016-05-01	434
2015: DELANO REGIONAL MEDICAL CENTER GROUP HEALTH PLAN 2015 401k membership
Total participants, beginning-of-year	2015-05-01	516
Total number of active participants reported on line 7a of the Form 5500	2015-05-01	502
Number of retired or separated participants receiving benefits	2015-05-01	0
Number of other retired or separated participants entitled to future benefits	2015-05-01	0
Total of all active and inactive participants	2015-05-01	502
2014: DELANO REGIONAL MEDICAL CENTER GROUP HEALTH PLAN 2014 401k membership
Total participants, beginning-of-year	2014-05-01	492
Total number of active participants reported on line 7a of the Form 5500	2014-05-01	516
Number of retired or separated participants receiving benefits	2014-05-01	0
Number of other retired or separated participants entitled to future benefits	2014-05-01	0
Total of all active and inactive participants	2014-05-01	516
2013: DELANO REGIONAL MEDICAL CENTER GROUP HEALTH PLAN 2013 401k membership
Total participants, beginning-of-year	2013-05-01	501
Total number of active participants reported on line 7a of the Form 5500	2013-05-01	488
Number of retired or separated participants receiving benefits	2013-05-01	4
Number of other retired or separated participants entitled to future benefits	2013-05-01	0
Total of all active and inactive participants	2013-05-01	492
2012: DELANO REGIONAL MEDICAL CENTER GROUP HEALTH PLAN 2012 401k membership
Total participants, beginning-of-year	2012-05-01	502
Total number of active participants reported on line 7a of the Form 5500	2012-05-01	501
Number of retired or separated participants receiving benefits	2012-05-01	0
Number of other retired or separated participants entitled to future benefits	2012-05-01	0
Total of all active and inactive participants	2012-05-01	501
2011: DELANO REGIONAL MEDICAL CENTER GROUP HEALTH PLAN 2011 401k membership
Total participants, beginning-of-year	2011-05-01	497
Total number of active participants reported on line 7a of the Form 5500	2011-05-01	501
Number of retired or separated participants receiving benefits	2011-05-01	1
Number of other retired or separated participants entitled to future benefits	2011-05-01	0
Total of all active and inactive participants	2011-05-01	502
2009: DELANO REGIONAL MEDICAL CENTER GROUP HEALTH PLAN 2009 401k membership
Total participants, beginning-of-year	2009-05-01	274
Total number of active participants reported on line 7a of the Form 5500	2009-05-01	459
Number of retired or separated participants receiving benefits	2009-05-01	16
Number of other retired or separated participants entitled to future benefits	2009-05-01	0
Total of all active and inactive participants	2009-05-01	475

Form 5500 Responses for DELANO REGIONAL MEDICAL CENTER GROUP HEALTH PLAN

2021: DELANO REGIONAL MEDICAL CENTER GROUP HEALTH PLAN 2021 form 5500 responses
2021-01-01	Type of plan entity	Single employer plan
2021-01-01	Submission has been amended	No
2021-01-01	This submission is the final filing	No
2021-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2021-01-01	Plan is a collectively bargained plan	No
2021-01-01	Plan funding arrangement – Insurance	Yes
2021-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2021-01-01	Plan benefit arrangement – Insurance	Yes
2021-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2020: DELANO REGIONAL MEDICAL CENTER GROUP HEALTH PLAN 2020 form 5500 responses
2020-01-01	Type of plan entity	Single employer plan
2020-01-01	Submission has been amended	No
2020-01-01	This submission is the final filing	No
2020-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2020-01-01	Plan is a collectively bargained plan	No
2020-01-01	Plan funding arrangement – Insurance	Yes
2020-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2020-01-01	Plan benefit arrangement – Insurance	Yes
2020-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2019: DELANO REGIONAL MEDICAL CENTER GROUP HEALTH PLAN 2019 form 5500 responses
2019-05-01	Type of plan entity	Single employer plan
2019-05-01	Submission has been amended	No
2019-05-01	This submission is the final filing	Yes
2019-05-01	This return/report is a short plan year return/report (less than 12 months)	Yes
2019-05-01	Plan is a collectively bargained plan	No
2019-05-01	Plan funding arrangement – Insurance	Yes
2019-05-01	Plan benefit arrangement – Insurance	Yes
2017: DELANO REGIONAL MEDICAL CENTER GROUP HEALTH PLAN 2017 form 5500 responses
2017-05-01	Type of plan entity	Single employer plan
2017-05-01	Submission has been amended	No
2017-05-01	This submission is the final filing	No
2017-05-01	This return/report is a short plan year return/report (less than 12 months)	No
2017-05-01	Plan is a collectively bargained plan	No
2017-05-01	Plan funding arrangement – Insurance	Yes
2017-05-01	Plan benefit arrangement – Insurance	Yes
2016: DELANO REGIONAL MEDICAL CENTER GROUP HEALTH PLAN 2016 form 5500 responses
2016-05-01	Type of plan entity	Single employer plan
2016-05-01	Submission has been amended	No
2016-05-01	This submission is the final filing	No
2016-05-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-05-01	Plan is a collectively bargained plan	No
2016-05-01	Plan funding arrangement – Insurance	Yes
2016-05-01	Plan benefit arrangement – Insurance	Yes
2015: DELANO REGIONAL MEDICAL CENTER GROUP HEALTH PLAN 2015 form 5500 responses
2015-05-01	Type of plan entity	Single employer plan
2015-05-01	Submission has been amended	No
2015-05-01	This submission is the final filing	No
2015-05-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-05-01	Plan is a collectively bargained plan	No
2015-05-01	Plan funding arrangement – Insurance	Yes
2015-05-01	Plan benefit arrangement – Insurance	Yes
2014: DELANO REGIONAL MEDICAL CENTER GROUP HEALTH PLAN 2014 form 5500 responses
2014-05-01	Type of plan entity	Single employer plan
2014-05-01	Submission has been amended	No
2014-05-01	This submission is the final filing	No
2014-05-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-05-01	Plan is a collectively bargained plan	No
2014-05-01	Plan funding arrangement – Insurance	Yes
2014-05-01	Plan benefit arrangement – Insurance	Yes
2013: DELANO REGIONAL MEDICAL CENTER GROUP HEALTH PLAN 2013 form 5500 responses
2013-05-01	Type of plan entity	Single employer plan
2013-05-01	Submission has been amended	No
2013-05-01	This submission is the final filing	No
2013-05-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-05-01	Plan is a collectively bargained plan	No
2013-05-01	Plan funding arrangement – Insurance	Yes
2013-05-01	Plan benefit arrangement – Insurance	Yes
2012: DELANO REGIONAL MEDICAL CENTER GROUP HEALTH PLAN 2012 form 5500 responses
2012-05-01	Type of plan entity	Single employer plan
2012-05-01	Submission has been amended	No
2012-05-01	This submission is the final filing	No
2012-05-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-05-01	Plan is a collectively bargained plan	No
2012-05-01	Plan funding arrangement – Insurance	Yes
2012-05-01	Plan benefit arrangement – Insurance	Yes
2011: DELANO REGIONAL MEDICAL CENTER GROUP HEALTH PLAN 2011 form 5500 responses
2011-05-01	Type of plan entity	Single employer plan
2011-05-01	Submission has been amended	No
2011-05-01	This submission is the final filing	No
2011-05-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-05-01	Plan is a collectively bargained plan	No
2011-05-01	Plan funding arrangement – Insurance	Yes
2011-05-01	Plan benefit arrangement – Insurance	Yes
2009: DELANO REGIONAL MEDICAL CENTER GROUP HEALTH PLAN 2009 form 5500 responses
2009-05-01	Type of plan entity	Single employer plan
2009-05-01	Submission has been amended	No
2009-05-01	This submission is the final filing	No
2009-05-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-05-01	Plan is a collectively bargained plan	No
2009-05-01	Plan funding arrangement – Insurance	Yes
2009-05-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number	30093394
Policy instance	7
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number	0218290
Policy instance	1
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number	0218289
Policy instance	2
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number	0146181
Policy instance	3
HYATT LEGAL PLANS (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number	1500182
Policy instance	4
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number	52700
Policy instance	5
DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number	20167
Policy instance	6
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract number	010-040593
Policy instance	1
BLUE SHIELD OF CALIFORNIA LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61557 )
Policy contract number	W0051534
Policy instance	2
CALIFORNIA PHYSICIANS SERVICE (National Association of Insurance Commissioners NAIC id number: 61557 )
Policy contract number	W0051534
Policy instance	3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract number	GLUG0AP5Y
Policy instance	4
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number	0218290
Policy instance	5
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number	0218289
Policy instance	6
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number	0146181
Policy instance	7
HYATT LEGAL PLANS (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number	1500182
Policy instance	8
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number	52700-1
Policy instance	9
DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number	20167
Policy instance	10
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number	30093394
Policy instance	11
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract number	010-040593
Policy instance	1
BLUE SHIELD OF CALIFORNIA LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61557 )
Policy contract number	W0051534
Policy instance	2
CALIFORNIA PHYSICIANS SERVICE (National Association of Insurance Commissioners NAIC id number: 61557 )
Policy contract number	W0051534
Policy instance	3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract number	GLUG0AP5Y
Policy instance	4
BLUE SHIELD OF CALIFORNIA LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61557 )
Policy contract number	W0051534
Policy instance	4
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract number	010-040593
Policy instance	3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract number	GLUG0AP5Y
Policy instance	2
CALIFORNIA PHYSICIANS SERVICE (National Association of Insurance Commissioners NAIC id number: 61557 )
Policy contract number	W0051534
Policy instance	1
CALIFORNIA PHYSICIANS SERVICE (National Association of Insurance Commissioners NAIC id number: 61557 )
Policy contract number	W0051534
Policy instance	1
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract number	GLUG0AP5Y
Policy instance	3
BLUE SHIELD OF CALIFORNIA LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61557 )
Policy contract number	W0051534
Policy instance	4
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract number	010-040593
Policy instance	2
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract number	010-040593
Policy instance	1
CALIFORNIA PHYSICIANS SERVICE (National Association of Insurance Commissioners NAIC id number: 61557 )
Policy contract number	H31028/H31027
Policy instance	2
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract number	GLUG0AP5Y
Policy instance	3
CALIFORNIA PHYSICIANS SERVICE (National Association of Insurance Commissioners NAIC id number: 61557 )
Policy contract number	H31027/H31026
Policy instance	4
DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number	5565
Policy instance	1
SAFEGUARD HEALTH PLANS INC (National Association of Insurance Commissioners NAIC id number: 79014 )
Policy contract number	97287297
Policy instance	2
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract number	GLUG0AP5Y
Policy instance	3
SAFEGUARD HEALTH PLANS INC (National Association of Insurance Commissioners NAIC id number: 79014 )
Policy contract number	97287297
Policy instance	2
DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number	5565
Policy instance	3
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract number	F007416
Policy instance	1
CALIFORNIA PHYSICIANS SERVICE (National Association of Insurance Commissioners NAIC id number: 61557 )
Policy contract number	H31027/H31026
Policy instance	4
DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number	5565
Policy instance	1
CALIFORNIA PHYSICIANS SERVICE (National Association of Insurance Commissioners NAIC id number: 61557 )
Policy contract number	H31027/H31026
Policy instance	4
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract number	F007416
Policy instance	3
SAFEGUARD HEALTH PLANS INC (National Association of Insurance Commissioners NAIC id number: 79014 )
Policy contract number	97287297
Policy instance	2
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract number	F007416
Policy instance	4
SAFEGUARD HEALTH PLANS INC (National Association of Insurance Commissioners NAIC id number: 79014 )
Policy contract number	287297
Policy instance	3
CALIFORNIA PHYSICIANS SERVICE (National Association of Insurance Commissioners NAIC id number: 61557 )
Policy contract number	H31027/H31026
Policy instance	2
DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number	5565
Policy instance	1

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Company Name:	ADVENTIST HEALTH DELANO
Employer identification number (EIN):	770258013
NAIC Classification:	622000
NAIC Description:	Hospitals