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| Plan Name | EASTSIDE HEALTH NETWORK HEALTH TRUST |
| Plan identification number | 501 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | EASTSIDE HEALTH NETWORK, LLC |
| Employer identification number (EIN): | 815483111 |
| NAIC Classification: | 524290 |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 501 | 2020-01-01 | ||||
| 501 | 2019-01-01 |
| Measure | Date | Value |
|---|---|---|
| 2020: EASTSIDE HEALTH NETWORK HEALTH TRUST 2020 401k membership | ||
| Total participants, beginning-of-year | 2020-01-01 | 72 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-01-01 | 0 |
| Number of retired or separated participants receiving benefits | 2020-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2020-01-01 | 0 |
| Total of all active and inactive participants | 2020-01-01 | 0 |
| 2019: EASTSIDE HEALTH NETWORK HEALTH TRUST 2019 401k membership | ||
| Total participants, beginning-of-year | 2019-01-01 | 68 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-01-01 | 72 |
| Number of retired or separated participants receiving benefits | 2019-01-01 | 1 |
| Total of all active and inactive participants | 2019-01-01 | 73 |
| 2020: EASTSIDE HEALTH NETWORK HEALTH TRUST 2020 form 5500 responses | ||
|---|---|---|
| 2020-01-01 | Type of plan entity | Mulitple employer plan |
| 2020-01-01 | This submission is the final filing | Yes |
| 2020-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2020-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2019: EASTSIDE HEALTH NETWORK HEALTH TRUST 2019 form 5500 responses | ||
| 2019-01-01 | Type of plan entity | Mulitple employer plan |
| 2019-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2019-01-01 | Plan benefit arrangement – Insurance | Yes |
| PREMERA BLUE CROSS (National Association of Insurance Commissioners NAIC id number: 47570 ) | |
| Policy contract number | 100000126 |
| Policy instance | 1 |
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