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AFFINITY HEALTH PARTNERS, INC. 401k Plan overview

Plan NameAFFINITY HEALTH PARTNERS, INC.
Plan identification number 501

AFFINITY HEALTH PARTNERS, INC. Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Vision
  • Temporary disability (accident and sickness)
  • Long-term disability cover
  • Death benefits (include travel accident but not life insurance)

401k Sponsoring company profile

AFFINITY HEALTH PARTNERS, INC. has sponsored the creation of one or more 401k plans.

Company Name:AFFINITY HEALTH PARTNERS, INC.
Employer identification number (EIN):834012219
NAIC Classification:622000
NAIC Description: Hospitals

Form 5500 Filing Information

Submission information for form 5500 for 401k plan AFFINITY HEALTH PARTNERS, INC.

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012021-08-01ENJONAY MORRIS2022-09-28

Plan Statistics for AFFINITY HEALTH PARTNERS, INC.

401k plan membership statisitcs for AFFINITY HEALTH PARTNERS, INC.

Measure Date Value
2021: AFFINITY HEALTH PARTNERS, INC. 2021 401k membership
Total participants, beginning-of-year2021-08-01103
Total number of active participants reported on line 7a of the Form 55002021-08-01106
Number of retired or separated participants receiving benefits2021-08-010
Number of other retired or separated participants entitled to future benefits2021-08-010
Total of all active and inactive participants2021-08-01106
Number of employers contributing to the scheme2021-08-010

Form 5500 Responses for AFFINITY HEALTH PARTNERS, INC.

2021: AFFINITY HEALTH PARTNERS, INC. 2021 form 5500 responses
2021-08-01Type of plan entitySingle employer plan
2021-08-01First time form 5500 has been submittedYes
2021-08-01This return/report is a short plan year return/report (less than 12 months)Yes
2021-08-01Plan funding arrangement – InsuranceYes
2021-08-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

ALL SAVERS INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 82406 )
Policy contract number5400-023463
Policy instance 1
Insurance contract or identification number5400-023463
Number of Individuals Covered65
Insurance policy start date2021-08-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $13,040
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $140,055
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $13,040
Amount paid for insurance broker fees0
Insurance broker organization code?3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number564084
Policy instance 2
Insurance contract or identification number564084
Number of Individuals Covered103
Insurance policy start date2021-08-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $8,322
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $73,046
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,322
Amount paid for insurance broker fees0
Insurance broker organization code?3

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