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BLUEGRASS HEALTH PARTNERS EMPLOYEE BENEFIT PLAN 401k Plan overview

Plan NameBLUEGRASS HEALTH PARTNERS EMPLOYEE BENEFIT PLAN
Plan identification number 501

BLUEGRASS HEALTH PARTNERS EMPLOYEE BENEFIT PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Vision

401k Sponsoring company profile

VALLEY STREAM OPERATOR 1 LLC DBA BLUEGRASS HEALTH PARTNERS has sponsored the creation of one or more 401k plans.

Company Name:VALLEY STREAM OPERATOR 1 LLC DBA BLUEGRASS HEALTH PARTNERS
Employer identification number (EIN):811010658
NAIC Classification:623000
NAIC Description: Nursing and Residential Care Facilities

Form 5500 Filing Information

Submission information for form 5500 for 401k plan BLUEGRASS HEALTH PARTNERS EMPLOYEE BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012024-03-01VALERIE PATE
5012024-02-01SAMUEL SCHLESINGER
5012023-03-01
5012023-03-01VALERIE PATE
5012023-02-01
5012023-02-01SAMUEL SCHLESINGER
5012022-02-01
5012022-02-01SAMUEL SCHLESINGER
5012017-02-01VALERIE PATE
5012016-08-01JOHN DAILEY

Financial Data on BLUEGRASS HEALTH PARTNERS EMPLOYEE BENEFIT PLAN

Measure Date Value
2024 : BLUEGRASS HEALTH PARTNERS EMPLOYEE BENEFIT PLAN 2024 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2024-01-31$677,321
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2024-01-31$530,797
Total income from all sources (including contributions)2024-01-31$3,657,009
Total of all expenses incurred2024-01-31$3,425,374
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2024-01-31$2,870,391
Total contributions o plan (from employers,participants, others, non cash contrinutions)2024-01-31$3,657,009
Value of total assets at end of year2024-01-31$854,159
Value of total assets at beginning of year2024-01-31$476,000
Total of administrative expenses incurred including professional, contract, advisory and management fees2024-01-31$554,983
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2024-01-31No
Was this plan covered by a fidelity bond2024-01-31Yes
Value of fidelity bond cover2024-01-31$500,000
If this is an individual account plan, was there a blackout period2024-01-31No
Were there any nonexempt tranactions with any party-in-interest2024-01-31No
Contributions received from participants2024-01-31$870,527
Administrative expenses (other) incurred2024-01-31$533
Liabilities. Value of operating payables at end of year2024-01-31$35,900
Total non interest bearing cash at end of year2024-01-31$663,591
Total non interest bearing cash at beginning of year2024-01-31$476,000
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2024-01-31No
Value of net income/loss2024-01-31$231,635
Value of net assets at end of year (total assets less liabilities)2024-01-31$176,838
Value of net assets at beginning of year (total assets less liabilities)2024-01-31$-54,797
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2024-01-31No
Were any loans by the plan or fixed income obligations due to the plan in default2024-01-31No
Were any leases to which the plan was party in default or uncollectible2024-01-31No
Value of interest in pooled separate accounts at end of year2024-01-31$0
Expenses. Payments to insurance carriers foe the provision of benefits2024-01-31$298,379
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2024-01-31No
Was there a failure to transmit to the plan any participant contributions2024-01-31No
Has the plan failed to provide any benefit when due under the plan2024-01-31No
Contributions received in cash from employer2024-01-31$2,786,482
Employer contributions (assets) at end of year2024-01-31$190,568
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2024-01-31$2,572,012
Contract administrator fees2024-01-31$321,950
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32024-01-31No
Liabilities. Value of benefit claims payable at end of year2024-01-31$641,421
Liabilities. Value of benefit claims payable at beginning of year2024-01-31$530,797
Did the plan have assets held for investment2024-01-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2024-01-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2024-01-31No
Opinion of an independent qualified public accountant for this plan2024-01-31Unqualified
Accountancy firm name2024-01-31FASTEN HALBERSTAM LLP
Accountancy firm EIN2024-01-31472319109
2023 : BLUEGRASS HEALTH PARTNERS EMPLOYEE BENEFIT PLAN 2023 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2023-02-01$677,321
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2023-02-01$530,797
Total income from all sources (including contributions)2023-02-01$3,657,009
Total of all expenses incurred2023-02-01$3,425,374
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2023-02-01$2,870,391
Total contributions o plan (from employers,participants, others, non cash contrinutions)2023-02-01$3,657,009
Value of total assets at end of year2023-02-01$854,159
Value of total assets at beginning of year2023-02-01$476,000
Total of administrative expenses incurred including professional, contract, advisory and management fees2023-02-01$554,983
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2023-02-01No
Was this plan covered by a fidelity bond2023-02-01Yes
Value of fidelity bond cover2023-02-01$500,000
If this is an individual account plan, was there a blackout period2023-02-01No
Were there any nonexempt tranactions with any party-in-interest2023-02-01No
Contributions received from participants2023-02-01$870,527
Administrative expenses (other) incurred2023-02-01$533
Liabilities. Value of operating payables at end of year2023-02-01$35,900
Total non interest bearing cash at end of year2023-02-01$663,591
Total non interest bearing cash at beginning of year2023-02-01$476,000
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2023-02-01No
Value of net income/loss2023-02-01$231,635
Value of net assets at end of year (total assets less liabilities)2023-02-01$176,838
Value of net assets at beginning of year (total assets less liabilities)2023-02-01$-54,797
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2023-02-01No
Were any loans by the plan or fixed income obligations due to the plan in default2023-02-01No
Were any leases to which the plan was party in default or uncollectible2023-02-01No
Value of interest in pooled separate accounts at end of year2023-02-01$0
Expenses. Payments to insurance carriers foe the provision of benefits2023-02-01$298,379
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2023-02-01No
Was there a failure to transmit to the plan any participant contributions2023-02-01No
Has the plan failed to provide any benefit when due under the plan2023-02-01No
Contributions received in cash from employer2023-02-01$2,786,482
Employer contributions (assets) at end of year2023-02-01$190,568
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2023-02-01$2,572,012
Contract administrator fees2023-02-01$321,950
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32023-02-01No
Liabilities. Value of benefit claims payable at end of year2023-02-01$641,421
Liabilities. Value of benefit claims payable at beginning of year2023-02-01$530,797
Did the plan have assets held for investment2023-02-01No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2023-02-01No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2023-02-01No
Opinion of an independent qualified public accountant for this plan2023-02-011
Accountancy firm name2023-02-01FASTEN HALBERSTAM LLP
Accountancy firm EIN2023-02-01472319109
Total transfer of assets to this plan2023-01-31$400,000
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2023-01-31$530,797
Total income from all sources (including contributions)2023-01-31$2,687,049
Total of all expenses incurred2023-01-31$3,141,846
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2023-01-31$2,884,346
Total contributions o plan (from employers,participants, others, non cash contrinutions)2023-01-31$2,687,049
Value of total assets at end of year2023-01-31$476,000
Total of administrative expenses incurred including professional, contract, advisory and management fees2023-01-31$257,500
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2023-01-31No
Was this plan covered by a fidelity bond2023-01-31No
If this is an individual account plan, was there a blackout period2023-01-31No
Were there any nonexempt tranactions with any party-in-interest2023-01-31No
Contributions received from participants2023-01-31$648,332
Total non interest bearing cash at end of year2023-01-31$476,000
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2023-01-31No
Value of net income/loss2023-01-31$-454,797
Value of net assets at end of year (total assets less liabilities)2023-01-31$-54,797
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2023-01-31No
Were any loans by the plan or fixed income obligations due to the plan in default2023-01-31No
Were any leases to which the plan was party in default or uncollectible2023-01-31No
Value of interest in pooled separate accounts at end of year2023-01-31$0
Expenses. Payments to insurance carriers foe the provision of benefits2023-01-31$228,152
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2023-01-31Yes
Was there a failure to transmit to the plan any participant contributions2023-01-31No
Has the plan failed to provide any benefit when due under the plan2023-01-31No
Contributions received in cash from employer2023-01-31$2,038,717
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2023-01-31$2,656,194
Contract administrator fees2023-01-31$257,500
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32023-01-31No
Liabilities. Value of benefit claims payable at end of year2023-01-31$530,797
Did the plan have assets held for investment2023-01-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2023-01-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2023-01-31No
Opinion of an independent qualified public accountant for this plan2023-01-31Unqualified
Accountancy firm name2023-01-31FASTEN HALBERSTAM LLP
Accountancy firm EIN2023-01-31472319109
2022 : BLUEGRASS HEALTH PARTNERS EMPLOYEE BENEFIT PLAN 2022 401k financial data
Total transfer of assets to this plan2022-02-01$400,000
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-02-01$530,797
Total income from all sources (including contributions)2022-02-01$2,687,049
Total of all expenses incurred2022-02-01$3,141,846
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-02-01$2,884,346
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-02-01$2,687,049
Value of total assets at end of year2022-02-01$476,000
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-02-01$257,500
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2022-02-01No
Was this plan covered by a fidelity bond2022-02-01No
If this is an individual account plan, was there a blackout period2022-02-01No
Were there any nonexempt tranactions with any party-in-interest2022-02-01No
Contributions received from participants2022-02-01$648,332
Total non interest bearing cash at end of year2022-02-01$476,000
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-02-01No
Value of net income/loss2022-02-01$-454,797
Value of net assets at end of year (total assets less liabilities)2022-02-01$-54,797
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2022-02-01No
Were any loans by the plan or fixed income obligations due to the plan in default2022-02-01No
Were any leases to which the plan was party in default or uncollectible2022-02-01No
Value of interest in pooled separate accounts at end of year2022-02-01$0
Expenses. Payments to insurance carriers foe the provision of benefits2022-02-01$228,152
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2022-02-01Yes
Was there a failure to transmit to the plan any participant contributions2022-02-01No
Has the plan failed to provide any benefit when due under the plan2022-02-01No
Contributions received in cash from employer2022-02-01$2,038,717
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2022-02-01$2,656,194
Contract administrator fees2022-02-01$257,500
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32022-02-01No
Liabilities. Value of benefit claims payable at end of year2022-02-01$530,797
Did the plan have assets held for investment2022-02-01No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2022-02-01No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2022-02-01No
Opinion of an independent qualified public accountant for this plan2022-02-011
Accountancy firm name2022-02-01FASTEN HALBERSTAM LLP
Accountancy firm EIN2022-02-01472319109

Form 5500 Responses for BLUEGRASS HEALTH PARTNERS EMPLOYEE BENEFIT PLAN

2023: BLUEGRASS HEALTH PARTNERS EMPLOYEE BENEFIT PLAN 2023 form 5500 responses
2023-03-01Type of plan entitySingle employer plan
2023-03-01Submission has been amendedNo
2023-03-01This submission is the final filingNo
2023-03-01This return/report is a short plan year return/report (less than 12 months)No
2023-03-01Plan is a collectively bargained planNo
2023-03-01Plan funding arrangement – InsuranceYes
2023-03-01Plan benefit arrangement – InsuranceYes
2023-02-01Type of plan entitySingle employer plan
2023-02-01Plan funding arrangement – TrustYes
2023-02-01Plan benefit arrangement – InsuranceYes
2023-02-01Plan benefit arrangement - TrustYes
2022: BLUEGRASS HEALTH PARTNERS EMPLOYEE BENEFIT PLAN 2022 form 5500 responses
2022-02-01Type of plan entitySingle employer plan
2022-02-01Plan funding arrangement – TrustYes
2022-02-01Plan benefit arrangement – InsuranceYes
2022-02-01Plan benefit arrangement - TrustYes
2017: BLUEGRASS HEALTH PARTNERS EMPLOYEE BENEFIT PLAN 2017 form 5500 responses
2017-02-01Type of plan entitySingle employer plan
2017-02-01Submission has been amendedNo
2017-02-01This submission is the final filingNo
2017-02-01This return/report is a short plan year return/report (less than 12 months)No
2017-02-01Plan is a collectively bargained planNo
2017-02-01Plan funding arrangement – InsuranceYes
2017-02-01Plan benefit arrangement – InsuranceYes
2016: BLUEGRASS HEALTH PARTNERS EMPLOYEE BENEFIT PLAN 2016 form 5500 responses
2016-08-01Type of plan entitySingle employer plan
2016-08-01Submission has been amendedNo
2016-08-01This submission is the final filingNo
2016-08-01This return/report is a short plan year return/report (less than 12 months)Yes
2016-08-01Plan is a collectively bargained planNo
2016-08-01Plan funding arrangement – InsuranceYes
2016-08-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

ANTHEM HEALTH PLAN OF KENTUCKY D.B.A. ANTHEM BLUECROSS BLUESHIELD (National Association of Insurance Commissioners NAIC id number: 95120 )
Policy contract numberW28078
Policy instance 1
Insurance contract or identification numberW28078
Number of Individuals Covered1322
Insurance policy start date2023-03-01
Insurance policy end date2024-02-29
Total amount of commissions paid to insurance brokerUSD $3,388
Total amount of fees paid to insurance companyUSD $1,694
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 BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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 $40,971
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SUN LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80926 )
Policy contract number824682
Policy instance 1
Insurance contract or identification number824682
Number of Individuals Covered747
Insurance policy start date2023-02-01
Insurance policy end date2024-01-31
Total amount of commissions paid to insurance brokerUSD $69,613
Welfare Benefit Premiums Paid to CarrierUSD $298,379
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SUN LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80926 )
Policy contract number824682
Policy instance 1
ANTHEM HEALTH PLAN OF KENTUCKY D.B.A. ANTHEM BLUECROSS BLUESHIELD (National Association of Insurance Commissioners NAIC id number: 95120 )
Policy contract number9545
Policy instance 1
ANTHEM HEALTH PLAN OF KENTUCKY D.B.A. ANTHEM BLUECROSS BLUESHIELD (National Association of Insurance Commissioners NAIC id number: 95120 )
Policy contract numberA74524
Policy instance 2

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