BAPTIST HEALTH RETIREMENT ACCUMULATION PLAN
|
2021
|
610444707
|
2022-10-15
|
BAPTIST HEALTHCARE SYSTEM INC.
|
16580
|
|
File |
View Page
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
1993-03-01
|
Business code |
622000
|
Sponsor’s telephone number |
5028965050
|
Plan sponsor’s mailing address |
2701 EASTPOINT PKWY, LOUISVILLE, KY, 402234166
|
Plan sponsor’s
address |
2701 EASTPOINT PKWY, LOUISVILLE, KY, 402234166
|
Number of participants as of the end of the plan year
Active participants |
15394 |
Retired or separated participants receiving
benefits |
82 |
Other
retired or separated participants entitled to future benefits |
1418 |
Deceased participants
whose
beneficiaries are receiving or are entitled to receive benefits |
30 |
Number of
participants
with
account balances as of the end of the plan year |
7673 |
Number of participants that
terminated
employment during the plan year with accrued benefits that were less than 100%
vested |
15 |
Signature of
Role |
Plan administrator |
Date |
2022-10-15 |
Name of individual signing |
SHARON MEHLING |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2022-10-15 |
Name of individual signing |
SHARON MEHLING |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BAPTIST HEALTH MEDICAL PLAN
|
2018
|
610444707
|
2019-07-29
|
BAPTIST HEALTHCARE SYSTEM INC.
|
12435
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
1983-03-01
|
Business code |
622000
|
Sponsor’s telephone number |
5028965000
|
Plan
sponsor’s DBA name |
SAME
|
Plan sponsor’s mailing address |
2701 EASTPOINT PKWY, LOUISVILLE, KY, 402234166
|
Plan sponsor’s
address |
2701 EASTPOINT PKWY, LOUISVILLE, KY, 402234166
|
Number of participants as of the end of the plan year
Active participants |
12435 |
Retired or separated participants receiving
benefits |
189 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2019-07-29 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
MANAGEMENT DISABILITY PLAN
|
2018
|
610444707
|
2019-07-29
|
BAPTIST HEALTHCARE SYSTEM, INC
|
931
|
|
File |
View Page
|
Three-digit plan number (PN) |
504
|
Effective date of plan |
2009-01-01
|
Business code |
622000
|
Sponsor’s telephone number |
5028965000
|
Plan
sponsor’s DBA name |
SAME
|
Plan sponsor’s mailing address |
2701 EASTPOINT PKWY, LOUISVILLE, KY, 402234166
|
Plan sponsor’s
address |
2701 EASTPOINT PKWY, LOUISVILLE, KY, 402234166
|
Signature of
Role |
Plan administrator |
Date |
2019-07-29 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
DENTAL PLAN
|
2018
|
610444707
|
2019-07-29
|
BAPTIST HEALTHCARE SYSTEM, INC.
|
28255
|
|
File |
View Page
|
Three-digit plan number (PN) |
506
|
Effective date of plan |
2012-01-01
|
Business code |
622000
|
Sponsor’s telephone number |
5028965000
|
Plan
sponsor’s DBA name |
SAME
|
Plan sponsor’s mailing address |
2701 EASTPOINT PKWY, LOUISVILLE, KY, 402234166
|
Plan sponsor’s
address |
2701 EASTPOINT PKWY, LOUISVILLE, KY, 402234166
|
Number of participants as of the end of the plan year
Active participants |
28255 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2019-07-29 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
ACCIDENT PLAN
|
2018
|
610444707
|
2019-07-30
|
BAPTIST HEALTHCARE SYSTEM INC.
|
5861
|
|
File |
View Page
|
Three-digit plan number (PN) |
514
|
Effective date of plan |
2018-01-01
|
Business code |
622000
|
Sponsor’s telephone number |
5028965000
|
Plan
sponsor’s DBA name |
SAME
|
Plan sponsor’s mailing address |
2701 EASTPOINT PKWY, LOUISVILLE, KY, 402234166
|
Plan sponsor’s
address |
2701 EASTPOINT PKWY, LOUISVILLE, KY, 402234166
|
Number of participants as of the end of the plan year
Active participants |
5861 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2019-07-30 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
VISION PLAN
|
2018
|
610444707
|
2019-07-30
|
BAPTIST HEALTHCARE SYSTEM, INC.
|
20045
|
|
File |
View Page
|
Three-digit plan number (PN) |
511
|
Effective date of plan |
2009-01-01
|
Business code |
622000
|
Sponsor’s telephone number |
5028965000
|
Plan
sponsor’s DBA name |
SAME
|
Plan sponsor’s mailing address |
2701 EASTPOINT PKWY, LOUISVILLE, KY, 402234166
|
Plan sponsor’s
address |
2701 EASTPOINT PKWY, LOUISVILLE, KY, 402234166
|
Number of participants as of the end of the plan year
Active participants |
20045 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2019-07-30 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BUSINESS TRAVEL ACCIDENT
|
2018
|
610444707
|
2019-07-30
|
BAPTIST HEALTHCARE SYSTEM, INC.
|
1209
|
|
File |
View Page
|
Three-digit plan number (PN) |
509
|
Effective date of plan |
1968-04-01
|
Business code |
622000
|
Sponsor’s telephone number |
5028965000
|
Plan
sponsor’s DBA name |
SAME
|
Plan sponsor’s mailing address |
2701 EASTPOINT PKWY, LOUISVILLE, KY, 402234166
|
Plan sponsor’s
address |
2701 EASTPOINT PKWY, LOUISVILLE, KY, 402234166
|
Number of participants as of the end of the plan year
Active participants |
1209 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2019-07-30 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
GROUP DISABILITY PLAN
|
2018
|
610444707
|
2019-07-29
|
BAPTIST HEALTHCARE SYSTEM, INC.
|
15577
|
|
File |
View Page
|
Three-digit plan number (PN) |
505
|
Effective date of plan |
2009-01-01
|
Business code |
622000
|
Sponsor’s telephone number |
5028965000
|
Plan
sponsor’s DBA name |
SAME
|
Plan sponsor’s mailing address |
2701 EASTPOINT PKWY, LOUISVILLE, KY, 402234166
|
Plan sponsor’s
address |
2701 EASTPOINT PKWY, LOUISVILLE, KY, 402234166
|
Number of participants as of the end of the plan year
Active participants |
15577 |
Retired or separated participants receiving
benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2019-07-29 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
CANCER PLAN
|
2018
|
610444707
|
2019-07-30
|
BAPTIST HEALTHCARE SYSTEM, INC.
|
4937
|
|
File |
View Page
|
Three-digit plan number (PN) |
512
|
Effective date of plan |
2010-01-01
|
Business code |
622000
|
Sponsor’s telephone number |
5028965000
|
Plan
sponsor’s DBA name |
SAME
|
Plan sponsor’s mailing address |
2701 EASTPOINT PKWY, LOUISVILLE, KY, 402234166
|
Plan sponsor’s
address |
2701 EASTPOINT PKWY, LOUISVILLE, KY, 402234166
|
Number of participants as of the end of the plan year
Active participants |
4937 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2019-07-30 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
SEVERANCE PLAN
|
2018
|
610444707
|
2019-07-29
|
BAPTIST HEALTHCARE SYSTEM, INC.
|
16482
|
|
File |
View Page
|
Three-digit plan number (PN) |
508
|
Effective date of plan |
1991-03-26
|
Business code |
622000
|
Sponsor’s telephone number |
5028965000
|
Plan
sponsor’s DBA name |
SAME
|
Plan sponsor’s mailing address |
2701 EASTPOINT PKWY, LOUISVILLE, KY, 402234166
|
Plan sponsor’s
address |
2701 EASTPOINT PKWY, LOUISVILLE, KY, 402234166
|
Number of participants as of the end of the plan year
Active participants |
16482 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2019-07-29 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
CRITICAL ILLNESS PLAN
|
2018
|
610444707
|
2019-07-30
|
BAPTIST HEALTHCARE SYSTEM, INC.
|
3770
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2019/07/30/20190730144913P030385784263001.pdf |
Three-digit plan number (PN) |
513 |
Effective date of plan |
2013-01-01 |
Business code |
622000 |
Sponsor’s telephone number |
5028965000 |
Plan
sponsor’s DBA name |
SAME |
Plan sponsor’s mailing address |
2701 EASTPOINT PKWY, LOUISVILLE, KY, 402234166 |
Plan sponsor’s
address |
2701 EASTPOINT PKWY, LOUISVILLE, KY, 402234166 |
Number of participants as of the end of the plan year
Active participants |
3770 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2019-07-30 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
SHORT TERM DISABILITY PLAN
|
2018
|
610444707
|
2019-07-29
|
BAPTIST HEALTHCARE SYSTEM, INC.
|
5945
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2019/07/29/20190729144737P040423927457001.pdf |
Three-digit plan number (PN) |
510 |
Effective date of plan |
1998-01-01 |
Business code |
622000 |
Sponsor’s telephone number |
5028965000 |
Plan
sponsor’s DBA name |
SAME |
Plan sponsor’s mailing address |
2701 EASTPOINT PKWY, LOUISVILLE, KY, 402234166 |
Plan sponsor’s
address |
2701 EASTPOINT PKWY, LOUISVILLE, KY, 402234166 |
Number of participants as of the end of the plan year
Active participants |
5945 |
Retired or separated participants receiving
benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2019-07-29 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
FLOYD MEMORIAL HOSPITAL AND HEALTH SERVICES
|
2017
|
610444707
|
2018-11-21
|
BAPTIST HEALTHCARE SYSTEM INC.
|
3766
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2018/11/21/20181121100659P030058312023001.pdf |
Three-digit plan number (PN) |
001 |
Effective date of plan |
2016-10-01 |
Business code |
622000 |
Sponsor’s telephone number |
5028965000 |
Plan
sponsor’s DBA name |
SAME |
Plan sponsor’s mailing address |
2701 EASTPOINT PKWY, LOUISVILLE, KY, 402234166 |
Plan sponsor’s
address |
2701 EASTPOINT PKWY, LOUISVILLE, KY, 402234166 |
Number of participants as of the end of the plan year
Active participants |
0 |
Number of
participants
with
account balances as of the end of the plan year |
0 |
Signature of
Role |
Plan administrator |
Date |
2018-11-21 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BUSINESS TRAVEL ACCIDENT
|
2017
|
610444707
|
2018-10-10
|
BAPTIST HEALTHCARE SYSTEM
|
1209
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2018/10/10/20181010133255P030233173431001.pdf |
Three-digit plan number (PN) |
509 |
Effective date of plan |
1968-04-01 |
Business code |
622000 |
Sponsor’s telephone number |
5028965000 |
Plan
sponsor’s DBA name |
SAME |
Plan sponsor’s mailing address |
2701 EASTPOINT PKWY, LOUISVILLE, KY, 402234166 |
Plan sponsor’s
address |
2701 EASTPOINT PKWY, LOUISVILLE, KY, 402234166 |
Number of participants as of the end of the plan year
Active participants |
1209 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2018-10-10 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2018-10-10 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
CANCER PLAN
|
2017
|
610444707
|
2018-10-10
|
BAPTIST HEALTHCARE SYSTEM
|
4632
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2018/10/10/20181010135637P030233228775001.pdf |
Three-digit plan number (PN) |
512 |
Effective date of plan |
2010-01-01 |
Business code |
622000 |
Sponsor’s telephone number |
5028965000 |
Plan
sponsor’s DBA name |
SAME |
Plan sponsor’s mailing address |
2701 EASTPOINT PKWY, LOUISVILLE, KY, 402234166 |
Plan sponsor’s
address |
2701 EASTPOINT PKWY, LOUISVILLE, KY, 402234166 |
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2018-10-10 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2018-10-10 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
CRITICAL ILLNESS PLAN
|
2017
|
610444707
|
2018-10-10
|
BAPTIST HEALTHCARE SYSTEM
|
3308
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2018/10/10/20181010140541P040159725677001.pdf |
Three-digit plan number (PN) |
513 |
Effective date of plan |
2013-01-01 |
Business code |
622000 |
Sponsor’s telephone number |
5028965000 |
Plan
sponsor’s DBA name |
SAME |
Plan sponsor’s mailing address |
2701 EASTPOINT PKWY, LOUISVILLE, KY, 402234166 |
Plan sponsor’s
address |
2701 EASTPOINT PKWY, LOUISVILLE, KY, 402234166 |
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2018-10-10 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2018-10-10 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
VISION PLAN
|
2017
|
610444707
|
2018-10-10
|
BAPTIST HEALTHCARE SYSTEM
|
20479
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2018/10/10/20181010134339P040086093023001.pdf |
Three-digit plan number (PN) |
511 |
Effective date of plan |
2009-01-01 |
Business code |
622000 |
Sponsor’s telephone number |
5028965000 |
Plan
sponsor’s DBA name |
SAME |
Plan sponsor’s mailing address |
2701 EASTPOINT PKWY, LOUISVILLE, KY, 402234166 |
Plan sponsor’s
address |
2701 EASTPOINT PKWY, LOUISVILLE, KY, 402234166 |
Number of participants as of the end of the plan year
Active participants |
20479 |
Signature of
Role |
Plan administrator |
Date |
2018-10-10 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2018-10-10 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
DENTAL PLAN
|
2017
|
610444707
|
2018-10-09
|
BAPTIST HEALTHCARE SYSTEM INC.
|
29054
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2018/10/09/20181009145438P040157861197001.pdf |
Three-digit plan number (PN) |
506 |
Effective date of plan |
2012-01-01 |
Business code |
622000 |
Sponsor’s telephone number |
5028965000 |
Plan
sponsor’s DBA name |
SAME |
Plan sponsor’s mailing address |
2701 EASTPOINT PKWY, LOUISVILLE, KY, 402234166 |
Plan sponsor’s
address |
2701 EASTPOINT PKWY, LOUISVILLE, KY, 402234166 |
Number of participants as of the end of the plan year
Active participants |
29054 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2018-10-09 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2018-10-09 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
GROUP DISABILITY PLAN
|
2017
|
610444707
|
2018-10-09
|
BAPTIST HEALTHCARE SYSTEM
|
11873
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2018/10/09/20181009144521P040157852237001.pdf |
Three-digit plan number (PN) |
505 |
Effective date of plan |
2009-01-01 |
Business code |
622000 |
Sponsor’s telephone number |
5028965000 |
Plan
sponsor’s DBA name |
SAME |
Plan sponsor’s mailing address |
2701 EASTPOINT PKWY, LOUISVILLE, KY, 402234166 |
Plan sponsor’s
address |
2701 EASTPOINT PKWY, LOUISVILLE, KY, 402234166 |
Number of participants as of the end of the plan year
Active participants |
11873 |
Signature of
Role |
Plan administrator |
Date |
2018-10-09 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2018-10-09 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
SEVERANCE PLAN
|
2017
|
610444707
|
2018-10-09
|
BAPTIST HEALTHCARE SYSTEM
|
13110
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2018/10/09/20181009151021P030230501783001.pdf |
Three-digit plan number (PN) |
508 |
Effective date of plan |
1991-03-26 |
Business code |
622000 |
Sponsor’s telephone number |
5028965000 |
Plan
sponsor’s DBA name |
SAME |
Plan sponsor’s mailing address |
2701 EASTPOINT PKWY, LOUISVILLE, KY, 402234166 |
Plan sponsor’s
address |
2701 EASTPOINT PKWY, LOUISVILLE, KY, 402234166 |
Number of participants as of the end of the plan year
Active participants |
13110 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2018-10-09 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2018-10-09 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
MANAGEMENT DISABILITY PLAN
|
2017
|
610444707
|
2018-10-09
|
BAPTIST HEALTHCARE SYSTEM INC.
|
886
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2018/10/09/20181009134119P040157766077001.pdf |
Three-digit plan number (PN) |
504 |
Effective date of plan |
2009-01-01 |
Business code |
622000 |
Sponsor’s telephone number |
5028965051 |
Plan
sponsor’s DBA name |
SAME |
Plan sponsor’s mailing address |
2701 EASTPOINT PKWY, LOUISVILLE, KY, 402234166 |
Plan sponsor’s
address |
2701 EASTPOINT PKWY, LOUISVILLE, KY, 402234166 |
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2018-10-09 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2018-10-09 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
SHORT TERM DISABILITY PLAN
|
2017
|
610444707
|
2018-10-09
|
BAPTIST HEALTHCARE SYSTEM INC.
|
4768
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2018/10/09/20181009153212P030168355165001.pdf |
Three-digit plan number (PN) |
510 |
Effective date of plan |
1998-01-01 |
Business code |
622000 |
Sponsor’s telephone number |
5028965000 |
Plan
sponsor’s DBA name |
SAME |
Plan sponsor’s mailing address |
2701 EASTPOINT PKWY, LOUISVILLE, KY, 402234166 |
Plan sponsor’s
address |
2701 EASTPOINT PKWY, LOUISVILLE, KY, 402234166 |
Number of participants as of the end of the plan year
Active participants |
4768 |
Retired or separated participants receiving
benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2018-10-09 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2018-10-09 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
ACCIDENTAL DEATH & DISMEMBERMENT PLAN
|
2017
|
610444707
|
2018-10-09
|
BAPTIST HEALTHCARE SYSTEM
|
13110
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2018/10/09/20181009131336P030252540401001.pdf |
Three-digit plan number (PN) |
503 |
Effective date of plan |
1968-04-01 |
Business code |
622000 |
Sponsor’s telephone number |
5028965000 |
Plan
sponsor’s DBA name |
SAME |
Plan sponsor’s mailing address |
2701 EASTPOINT PKWY, LOUISVILLE, KY, 402234166 |
Plan sponsor’s
address |
2701 EASTPOINT PKWY, LOUISVILLE, KY, 402234166 |
Number of participants as of the end of the plan year
Active participants |
0 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2018-10-09 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2018-10-09 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BAPTIST HEALTH PLAN MEDICAL
|
2017
|
610444707
|
2018-10-08
|
BAPTIST HEALTHCARE SYSTEM INC.
|
12684
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2018/10/08/20181008150755P030228575223001.pdf |
Three-digit plan number (PN) |
501 |
Effective date of plan |
1983-03-01 |
Business code |
622000 |
Sponsor’s telephone number |
5028965000 |
Plan
sponsor’s DBA name |
SAME |
Plan sponsor’s mailing address |
2701 EASTPOINT PKWY, LOUISVILLE, KY, 402234166 |
Plan sponsor’s
address |
2701 EASTPOINT PKWY, LOUISVILLE, KY, 402234166 |
Number of participants as of the end of the plan year
Active participants |
12684 |
Retired or separated participants receiving
benefits |
176 |
Other
retired or separated participants entitled to future benefits |
0 |
Deceased participants
whose
beneficiaries are receiving or are entitled to receive benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2018-10-08 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2018-10-08 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
FLOYD MEMORIAL HOSPITAL AND HEALTH SERVICES
|
2016
|
610444707
|
2018-11-21
|
BAPTIST HEALTHCARE SYSTEM INC.
|
3666
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2018/11/21/20181121093823P030058259191001.pdf |
Three-digit plan number (PN) |
001 |
Effective date of plan |
2016-10-01 |
Business code |
622000 |
Sponsor’s telephone number |
5028965000 |
Plan
sponsor’s DBA name |
SAME |
Plan sponsor’s mailing address |
2701 EASTPOINT PKWY, LOUISVILLE, KY, 402234166 |
Plan sponsor’s
address |
2701 EASTPOINT PKWY, LOUISVILLE, KY, 402234166 |
Number of participants as of the end of the plan year
Active participants |
2527 |
Retired or separated participants receiving
benefits |
3 |
Other
retired or separated participants entitled to future benefits |
1309 |
Deceased participants
whose
beneficiaries are receiving or are entitled to receive benefits |
2 |
Number of
participants
with
account balances as of the end of the plan year |
3766 |
Number of participants that
terminated
employment during the plan year with accrued benefits that were less than 100%
vested |
197 |
Signature of
Role |
Plan administrator |
Date |
2018-11-21 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
ACCIDENT PLAN
|
2016
|
610444707
|
2017-07-31
|
BAPTIST HEALTHCARE SYSTEM
|
4104
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2017/07/31/20170731114833P030057109501001.pdf |
Three-digit plan number (PN) |
518 |
Effective date of plan |
2016-01-01 |
Business code |
622000 |
Sponsor’s telephone number |
5028965000 |
Plan
sponsor’s DBA name |
SAME |
Plan sponsor’s mailing address |
2701 EASTPOINT PKWY, LOUISVILLE, KY, 402234166 |
Plan sponsor’s
address |
2701 EASTPOINT PKWY, LOUISVILLE, KY, 402234166 |
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2017-07-31 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
CANCER PLAN
|
2016
|
610444707
|
2017-07-31
|
BAPTIST HEALTHCARE SYSTEM
|
4346
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2017/07/31/20170731112433P040060151901001.pdf |
Three-digit plan number (PN) |
512 |
Effective date of plan |
2010-01-01 |
Business code |
622000 |
Sponsor’s telephone number |
5028965000 |
Plan
sponsor’s DBA name |
SAME |
Plan sponsor’s mailing address |
2701 EASTPOINT PKWY, LOUISVILLE, KY, 402234166 |
Plan sponsor’s
address |
2701 EASTPOINT PKWY, LOUISVILLE, KY, 402234166 |
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2017-07-31 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
CRITICAL ILLNESS PLAN
|
2016
|
610444707
|
2017-07-31
|
BAPTIST HEALTHCARE SYSTEM
|
2596
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2017/07/31/20170731113559P030057081757001.pdf |
Three-digit plan number (PN) |
513 |
Effective date of plan |
2013-01-01 |
Business code |
622000 |
Sponsor’s telephone number |
5028965000 |
Plan
sponsor’s DBA name |
SAME |
Plan sponsor’s mailing address |
2701 EASTPOINT PKWY, LOUISVILLE, KY, 402234166 |
Plan sponsor’s
address |
2701 EASTPOINT PKWY, LOUISVILLE, KY, 402234166 |
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2017-07-31 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BUSINESS TRAVEL ACCIDENT PLAN
|
2016
|
610444707
|
2017-07-31
|
BAPTIST HEALTHCARE SYSTEM
|
325
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2017/07/31/20170731115608P040060190045001.pdf |
Three-digit plan number (PN) |
509 |
Effective date of plan |
1968-04-01 |
Business code |
622000 |
Sponsor’s telephone number |
5028965000 |
Plan
sponsor’s DBA name |
SAME |
Plan sponsor’s mailing address |
2701 EASTPOINT PKWY, LOUISVILLE, KY, 402234166 |
Plan sponsor’s
address |
2701 EASTPOINT PKWY, LOUISVILLE, KY, 402234166 |
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2017-07-31 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
VISION PLAN
|
2016
|
610444707
|
2017-07-28
|
BAPTIST HEALTHCARE SYSTEM
|
20203
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2017/07/28/20170728151533P040062124663001.pdf |
Three-digit plan number (PN) |
511 |
Effective date of plan |
2009-01-01 |
Business code |
622000 |
Sponsor’s telephone number |
5028965000 |
Plan
sponsor’s DBA name |
SAME |
Plan sponsor’s mailing address |
2701 EASTPOINT PKWY, LOUISVILLE, KY, 402234166 |
Plan sponsor’s
address |
2701 EASTPOINT PKWY, LOUISVILLE, KY, 402234166 |
Number of participants as of the end of the plan year
Active participants |
20203 |
Signature of
Role |
Plan administrator |
Date |
2017-07-28 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
MANAGEMENT DISABILITY PLAN
|
2016
|
610444707
|
2017-07-28
|
BAPTIST HEALTHCARE SYSTEM
|
886
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2017/07/28/20170728140901P040062053751001.pdf |
Three-digit plan number (PN) |
504 |
Effective date of plan |
2009-01-01 |
Business code |
622000 |
Sponsor’s telephone number |
5028965000 |
Plan
sponsor’s DBA name |
SAME |
Plan sponsor’s mailing address |
2701 EASTPOINT PKWY, LOUISVILLE, KY, 402234166 |
Plan sponsor’s
address |
2701 EASTPOINT PKWY, LOUISVILLE, KY, 402234166 |
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2017-07-28 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
SEVERANCE PLAN
|
2016
|
610444707
|
2017-07-28
|
BAPTIST HEALTHCARE SYSTEM
|
17118
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2017/07/28/20170728144803P030054551645001.pdf |
Three-digit plan number (PN) |
508 |
Effective date of plan |
1991-03-26 |
Business code |
622000 |
Sponsor’s telephone number |
5028965000 |
Plan
sponsor’s DBA name |
SAME |
Plan sponsor’s mailing address |
2701 EASTPOINT PKWY, LOUISVILLE, KY, 402234166 |
Plan sponsor’s
address |
2701 EASTPOINT PKWY, LOUISVILLE, KY, 402234166 |
Number of participants as of the end of the plan year
Active participants |
17118 |
Signature of
Role |
Plan administrator |
Date |
2017-07-28 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
GROUP DISABILITY PLAN
|
2016
|
610444707
|
2017-07-28
|
BAPTIST HEALTHCARE SYSTEM
|
12713
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2017/07/28/20170728141953P040062066919001.pdf |
Three-digit plan number (PN) |
505 |
Effective date of plan |
2009-01-01 |
Business code |
622000 |
Sponsor’s telephone number |
5028965000 |
Plan
sponsor’s DBA name |
SAME |
Plan sponsor’s mailing address |
2701 EASTPOINT PKWY, LOUISVILLE, KY, 402234166 |
Plan sponsor’s
address |
2701 EASTPOINT PKWY, LOUISVILLE, KY, 402234166 |
Number of participants as of the end of the plan year
Active participants |
12713 |
Signature of
Role |
Plan administrator |
Date |
2017-07-28 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
SHORT TERM DISABILITY PLAN
|
2016
|
610444707
|
2017-07-28
|
BAPTIST HEALTHCARE SYSTEM
|
4834
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2017/07/28/20170728150153P030054582141001.pdf |
Three-digit plan number (PN) |
510 |
Effective date of plan |
1998-01-01 |
Business code |
622000 |
Sponsor’s telephone number |
5028963000 |
Plan
sponsor’s DBA name |
SAME |
Plan sponsor’s mailing address |
2701 EASTPOINT PKWY, LOUISVILLE, KY, 402234166 |
Plan sponsor’s
address |
2701 EASTPOINT PKWY, LOUISVILLE, KY, 402234166 |
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2017-07-28 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
GROUP LIFE
|
2016
|
610444707
|
2017-07-28
|
BAPTIST HEALTHCARE SYSTEM
|
17118
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2017/07/28/20170728100649P040061640023001.pdf |
Three-digit plan number (PN) |
502 |
Effective date of plan |
1968-04-01 |
Business code |
622000 |
Sponsor’s telephone number |
5028965000 |
Plan sponsor’s mailing address |
2701 EASTPOINT PKWY, LOUISVILLE, KY, 402234166 |
Plan sponsor’s
address |
2701 EASTPOINT PKWY, LOUISVILLE, KY, 402234166 |
Number of participants as of the end of the plan year
Active participants |
15493 |
Retired or separated participants receiving
benefits |
1625 |
Signature of
Role |
Plan administrator |
Date |
2017-07-28 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
DENTAL PLAN
|
2016
|
610444707
|
2017-07-28
|
BAPTIST HEALTHCARE SYSTEM
|
25103
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2017/07/28/20170728143948P030054532269001.pdf |
Three-digit plan number (PN) |
506 |
Effective date of plan |
2012-01-01 |
Business code |
622000 |
Sponsor’s telephone number |
5028965000 |
Plan
sponsor’s DBA name |
SAME |
Plan sponsor’s mailing address |
2701 EASTPOINT PKWY, LOUISVILLE, KY, 402234166 |
Plan sponsor’s
address |
2701 EASTPOINT PKWY, LOUISVILLE, KY, 402234166 |
Number of participants as of the end of the plan year
Active participants |
25103 |
Signature of
Role |
Plan administrator |
Date |
2017-07-28 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
MADISONVILLE HEALTH PLAN
|
2015
|
610444707
|
2016-10-17
|
BAPTIST HEALTHCARE SYSTEM
|
1011
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2016/10/17/20161017092240P040030565415001.pdf |
Three-digit plan number (PN) |
517 |
Effective date of plan |
1994-02-01 |
Business code |
622000 |
Sponsor’s telephone number |
5028965000 |
Plan
sponsor’s DBA name |
SAME |
Plan sponsor’s mailing address |
2701 EASTPOINT PKWY, LOUISVILLE, KY, 402234166 |
Plan sponsor’s
address |
2701 EASTPOINT PKWY, LOUISVILLE, KY, 402234166 |
Number of participants as of the end of the plan year
Active participants |
0 |
Retired or separated participants receiving
benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2016-10-17 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2016-10-17 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BUSINESS TRAVEL ACCIDENT PLAN
|
2015
|
610444707
|
2016-10-10
|
BAPTIST HEALTHCARE SYSTEM
|
325
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2016/10/10/20161010090806P040016227191001.pdf |
Three-digit plan number (PN) |
509 |
Effective date of plan |
1968-04-01 |
Business code |
622000 |
Sponsor’s telephone number |
5028965000 |
Plan
sponsor’s DBA name |
SAME |
Plan sponsor’s mailing address |
2701 EASTPOINT PKWY, LOUISVILLE, KY, 402234166 |
Plan sponsor’s
address |
2701 EASTPOINT PKWY, LOUISVILLE, KY, 402234166 |
Number of participants as of the end of the plan year
Active participants |
0 |
Retired or separated participants receiving
benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2016-10-10 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2016-10-10 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
DENTAL PLAN
|
2015
|
610444707
|
2016-09-28
|
BAPTIST HEALTHCARE SYSTEM INC.
|
22799
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2016/09/28/20160928100259P030015670033001.pdf |
Three-digit plan number (PN) |
506 |
Effective date of plan |
2012-01-01 |
Business code |
622000 |
Sponsor’s telephone number |
5028965000 |
Plan
sponsor’s DBA name |
SAME |
Plan sponsor’s mailing address |
2701 EASTPOINT PKWY, LOUISVILLE, KY, 402234166 |
Plan sponsor’s
address |
2701 EASTPOINT PKWY, LOUISVILLE, KY, 402234166 |
Signature of
Role |
Plan administrator |
Date |
2016-09-28 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2016-09-28 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
CANCER PLAN
|
2015
|
610444707
|
2016-10-10
|
BAPTIST HEALTHCARE SYSTEM
|
5926
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2016/10/10/20161010085150P030018570017001.pdf |
Three-digit plan number (PN) |
512 |
Effective date of plan |
2010-01-01 |
Business code |
622000 |
Sponsor’s telephone number |
5028965000 |
Plan
sponsor’s DBA name |
SAME |
Plan sponsor’s mailing address |
2701 EASTPOINT PKWY, LOUISVILLE, KY, 402234166 |
Plan sponsor’s
address |
2701 EASTPOINT PKWY, LOUISVILLE, KY, 402234166 |
Number of participants as of the end of the plan year
Active participants |
0 |
Retired or separated participants receiving
benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2016-10-10 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2016-10-10 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
MANAGEMENT DISABILITY PLAN
|
2015
|
610444707
|
2016-10-13
|
BAPTIST HEALTHCARE SYSTEM
|
857
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2016/10/13/20161013142717P030023721335001.pdf |
Three-digit plan number (PN) |
504 |
Effective date of plan |
2009-01-01 |
Business code |
622000 |
Sponsor’s telephone number |
5028965000 |
Plan
sponsor’s DBA name |
SAME |
Plan sponsor’s mailing address |
2701 EASTPOINT PKWY, LOUISVILLE, KY, 402234166 |
Plan sponsor’s
address |
2701 EASTPOINT PKWY, LOUISVILLE, KY, 402234166 |
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2016-10-13 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2016-10-13 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
GROUP LIFE
|
2015
|
610444707
|
2016-10-13
|
BAPTIST HEALTHCARE SYSTEM
|
16352
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2016/10/13/20161013134621P040014066253001.pdf |
Three-digit plan number (PN) |
502 |
Effective date of plan |
1968-04-01 |
Business code |
622000 |
Sponsor’s telephone number |
5028965000 |
Plan
sponsor’s DBA name |
SAME |
Plan sponsor’s mailing address |
2701 EASTPOINT PKWY, LOUISVILLE, KY, 402234166 |
Plan sponsor’s
address |
2701 EASTPOINT PKWY, LOUISVILLE, KY, 402234166 |
Number of participants as of the end of the plan year
Active participants |
14840 |
Retired or separated participants receiving
benefits |
1512 |
Signature of
Role |
Plan administrator |
Date |
2016-10-13 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2016-10-13 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
GROUP DISABILITY PLAN
|
2015
|
610444707
|
2016-10-13
|
BAPTIST HEALTHCARE SYSTEM
|
11529
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2016/10/13/20161013143723P030016217645001.pdf |
Three-digit plan number (PN) |
505 |
Effective date of plan |
2009-01-01 |
Business code |
622000 |
Sponsor’s telephone number |
5028965000 |
Plan
sponsor’s DBA name |
SAME |
Plan sponsor’s mailing address |
2701 EASTPOINT PKWY, LOUISVILLE, KY, 402234166 |
Plan sponsor’s
address |
2701 EASTPOINT PKWY, LOUISVILLE, KY, 402234166 |
Number of participants as of the end of the plan year
Active participants |
11529 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2016-10-13 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2016-10-13 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BRMC HEALTH PLAN
|
2015
|
610444707
|
2016-10-13
|
BAPTIST HEALTHCARE SYSTEM
|
1232
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2016/10/13/20161013095838P030023077319001.pdf |
Three-digit plan number (PN) |
501 |
Effective date of plan |
2013-01-01 |
Business code |
622000 |
Sponsor’s telephone number |
5028965000 |
Plan
sponsor’s DBA name |
SAME |
Plan sponsor’s mailing address |
2701 EASTPOINT PKWY, LOUISVILLE, KY, 402234166 |
Plan sponsor’s
address |
2701 EASTPOINT PKWY, LOUISVILLE, KY, 402234166 |
Number of participants as of the end of the plan year
Active participants |
1226 |
Retired or separated participants receiving
benefits |
6 |
Signature of
Role |
Plan administrator |
Date |
2016-10-13 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2016-10-13 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
ACCIDENTAL DEATH & DISMEMBERMENT
|
2015
|
610444707
|
2016-10-13
|
BAPTIST HEALTHCARE SYSTEM
|
14840
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2016/10/13/20161013133431P040023230055001.pdf |
Three-digit plan number (PN) |
503 |
Effective date of plan |
1968-04-01 |
Business code |
622000 |
Sponsor’s telephone number |
5028965000 |
Plan
sponsor’s DBA name |
SAME |
Plan sponsor’s mailing address |
2701 EASTPOINT PKWY, LOUISVILLE, KY, 402234166 |
Plan sponsor’s
address |
2701 EASTPOINT PKWY, LOUISVILLE, KY, 402234166 |
Number of participants as of the end of the plan year
Active participants |
0 |
Retired or separated participants receiving
benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2016-10-13 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2016-10-13 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BAPTIST LEXINGTON HEALTH PLAN
|
2015
|
610444707
|
2016-10-13
|
BAPTIST HEALTHCARE SYSTEM
|
2700
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2016/10/13/20161013094427P040025230737001.pdf |
Three-digit plan number (PN) |
516 |
Effective date of plan |
2013-01-01 |
Business code |
622000 |
Sponsor’s telephone number |
5028965000 |
Plan
sponsor’s DBA name |
SAME |
Plan sponsor’s mailing address |
2701 EASTPOINT PKWY, LOUISVILLE, KY, 402234166 |
Plan sponsor’s
address |
2701 EASTPOINT PKWY, LOUISVILLE, KY, 402234166 |
Number of participants as of the end of the plan year
Active participants |
2670 |
Retired or separated participants receiving
benefits |
30 |
Signature of
Role |
Plan administrator |
Date |
2016-10-13 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2016-10-13 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
SHORT TERM DISABILITY PLAN
|
2015
|
610444707
|
2016-10-12
|
BAPTIST HEALTHCARE SYSTEM
|
4665
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2016/10/12/20161012144626P040023718305001.pdf |
Three-digit plan number (PN) |
510 |
Effective date of plan |
1998-01-01 |
Business code |
622000 |
Sponsor’s telephone number |
5028986500 |
Plan
sponsor’s DBA name |
SAME |
Plan sponsor’s mailing address |
2701 EASTPOINT PKWY, LOUISVILLE, KY, 402234166 |
Plan sponsor’s
address |
2701 EASTPOINT PKWY, LOUISVILLE, KY, 402234166 |
Number of participants as of the end of the plan year
Active participants |
0 |
Retired or separated participants receiving
benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2016-10-12 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2016-10-12 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BAPTIST RICHMOND HEALTH PLAN
|
2015
|
610444707
|
2016-10-12
|
BAPTIST HEALTHCARE SYSTEM
|
512
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2016/10/12/20161012145743P030021466375001.pdf |
Three-digit plan number (PN) |
515 |
Effective date of plan |
2012-01-01 |
Business code |
622000 |
Sponsor’s telephone number |
5028965000 |
Plan
sponsor’s DBA name |
SAME |
Plan sponsor’s mailing address |
2701 EASTPOINT PKWY, LOUISVILLE, KY, 402234166 |
Plan sponsor’s
address |
2701 EASTPOINT PKWY, LOUISVILLE, KY, 402234166 |
Number of participants as of the end of the plan year
Active participants |
0 |
Retired or separated participants receiving
benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2016-10-12 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2016-10-12 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
CRITICAL ILLNESS PLAN
|
2015
|
610444707
|
2016-10-11
|
BAPTIST HEALTHCARE SYSTEM
|
962
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2016/10/11/20161011104020P040021115889001.pdf |
Three-digit plan number (PN) |
513 |
Effective date of plan |
2013-01-01 |
Business code |
622000 |
Sponsor’s telephone number |
5028965000 |
Plan
sponsor’s DBA name |
SAME |
Plan sponsor’s mailing address |
2701 EASTPOINT PKWY, LOUISVILLE, KY, 402234166 |
Plan sponsor’s
address |
2701 EASTPOINT PKWY, LOUISVILLE, KY, 402234166 |
Number of participants as of the end of the plan year
Active participants |
0 |
Retired or separated participants receiving
benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2016-10-11 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2016-10-11 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
SEVERANCE PLAN
|
2015
|
610444707
|
2016-10-11
|
BAPTIST HEALTHCARE SYSTEM
|
14840
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2016/10/11/20161011102203P030018443911001.pdf |
Three-digit plan number (PN) |
508 |
Effective date of plan |
1991-03-26 |
Business code |
622000 |
Sponsor’s telephone number |
5028965000 |
Plan
sponsor’s DBA name |
SAME |
Plan sponsor’s mailing address |
2701 EASTPOINT PKWY, LOUISVILLE, KY, 402234166 |
Plan sponsor’s
address |
2701 EASTPOINT PKWY, LOUISVILLE, KY, 402234166 |
Number of participants as of the end of the plan year
Active participants |
0 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2016-10-11 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2016-10-11 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
VISION PLAN - 511
|
2015
|
610444707
|
2016-10-10
|
BAPTIST HEALTHCARE SYSTEM INC.
|
17742
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2016/10/10/20161010083800P030011990317001.pdf |
Three-digit plan number (PN) |
511 |
Effective date of plan |
2009-01-01 |
Business code |
622000 |
Sponsor’s telephone number |
5028965000 |
Plan
sponsor’s DBA name |
SAME |
Plan sponsor’s mailing address |
2701 EASTPOINT PKWY, LOUISVILLE, KY, 402234166 |
Plan sponsor’s
address |
2701 EASTPOINT PKWY, LOUISVILLE, KY, 402234166 |
Signature of
Role |
Plan administrator |
Date |
2016-10-10 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2016-10-10 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BRMC HEALTH PLAN
|
2014
|
610444707
|
2015-07-14
|
BAPTIST HEALTHCARE SYSTEM
|
1106
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2015/07/14/20150714133739P030112296593001.pdf |
Three-digit plan number (PN) |
501 |
Effective date of plan |
2013-01-01 |
Business code |
622000 |
Sponsor’s telephone number |
5028965000 |
Plan sponsor’s mailing address |
2701 EASTPOINT PARKWAY, LOUISVILLE, KY, 40223 |
Plan sponsor’s
address |
2701 EASTPOINT PARKWAY, LOUISVILLE, KY, 40223 |
Number of participants as of the end of the plan year
Active participants |
1100 |
Retired or separated participants receiving
benefits |
6 |
Signature of
Role |
Plan administrator |
Date |
2015-07-14 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2015-07-14 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
GROUP DISABILITY PLAN
|
2014
|
610444707
|
2015-07-14
|
BAPTIST HEALTHCARE SYSTEM
|
9350
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2015/07/14/20150714151856P030112467281001.pdf |
Three-digit plan number (PN) |
505 |
Effective date of plan |
2009-01-01 |
Business code |
622000 |
Sponsor’s telephone number |
5028965000 |
Plan sponsor’s mailing address |
2701 EASTPOINT PARKWAY, LOUISVILLE, KY, 40223 |
Plan sponsor’s
address |
2701 EASTPOINT PARKWAY, LOUISVILLE, KY, 40223 |
Number of participants as of the end of the plan year
Active participants |
0 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2015-07-14 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2015-07-14 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BAPTIST LEXINGTON HEALTH PLAN
|
2014
|
610444707
|
2015-07-15
|
BAPTIST HEALTHCARE SYSTEM
|
2668
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2015/07/15/20150715094728P040114820785001.pdf |
Three-digit plan number (PN) |
516 |
Effective date of plan |
2013-01-01 |
Business code |
622000 |
Sponsor’s telephone number |
5028965000 |
Plan sponsor’s mailing address |
2701 EASTPOINT PKWY, LOUISVILLE, KY, 40223 |
Plan sponsor’s
address |
2701 EASTPOINT PKWY, LOUISVILLE, KY, 40223 |
Number of participants as of the end of the plan year
Active participants |
2643 |
Retired or separated participants receiving
benefits |
25 |
Signature of
Role |
Plan administrator |
Date |
2015-07-15 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2015-07-15 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
SHORT TERM DISABILITY PLAN
|
2014
|
610444707
|
2015-07-15
|
BAPTIST HEALTHCARE SYSTEM
|
2339
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2015/07/15/20150715092433P040093150823001.pdf |
Three-digit plan number (PN) |
510 |
Effective date of plan |
1998-01-01 |
Business code |
622000 |
Sponsor’s telephone number |
5028965000 |
Plan sponsor’s mailing address |
2701 EASTPOINT PARKWAY, LOUISVILLE, KY, 40223 |
Plan sponsor’s
address |
2701 EASTPOINT PARKWAY, LOUISVILLE, KY, 40223 |
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2015-07-15 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2015-07-15 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
MADISONVILLE HEALTH PLAN
|
2014
|
610444707
|
2015-07-15
|
BAPTIST HEALTHCARE SYSTEM
|
1203
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2015/07/15/20150715104339P030114105713001.pdf |
Three-digit plan number (PN) |
517 |
Effective date of plan |
1994-02-01 |
Business code |
622000 |
Sponsor’s telephone number |
5028965000 |
Plan sponsor’s mailing address |
2701 EASTPOINT PARKWAY, LOUISVILLE, KY, 40223 |
Plan sponsor’s
address |
2701 EASTPOINT PARKWAY, LOUISVILLE, KY, 40223 |
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2015-07-15 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2015-07-15 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
HEALTH PLAN
|
2014
|
610444707
|
2015-07-14
|
BAPTIST HEALTHCARE SYSTEM
|
5712
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2015/07/14/20150714132629P030096413367001.pdf |
Three-digit plan number (PN) |
501 |
Effective date of plan |
1983-03-01 |
Business code |
622000 |
Sponsor’s telephone number |
5028965000 |
Plan sponsor’s mailing address |
2701 EASTPOINT PARKWAY, LOUISVILLE, KY, 40223 |
Plan sponsor’s
address |
2701 EASTPOINT PARKWAY, LOUISVILLE, KY, 40223 |
Number of participants as of the end of the plan year
Active participants |
5612 |
Retired or separated participants receiving
benefits |
100 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2015-07-14 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2015-07-14 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
VISION PLAN
|
2014
|
610444707
|
2015-07-15
|
BAPTIST HEALTHCARE SYSTEM
|
7366
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2015/07/15/20150715093437P040035901725001.pdf |
Three-digit plan number (PN) |
511 |
Effective date of plan |
2009-01-01 |
Business code |
622000 |
Sponsor’s telephone number |
5028965000 |
Plan sponsor’s mailing address |
2701 EASTPOINT PARKWAY, LOUISVILLE, KY, 40223 |
Plan sponsor’s
address |
2701 EASTPOINT PARKWAY, LOUISVILLE, KY, 40223 |
Number of participants as of the end of the plan year
Active participants |
0 |
Retired or separated participants receiving
benefits |
0 |
Deceased participants
whose
beneficiaries are receiving or are entitled to receive benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2015-07-15 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2015-07-15 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BAPTIST RICHMOND HEALTH PLAN
|
2014
|
610444707
|
2015-07-14
|
BAPTIST HEALTHCARE SYSTEM
|
424
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2015/07/14/20150714141233P040113235681001.pdf |
Three-digit plan number (PN) |
515 |
Effective date of plan |
2012-01-01 |
Business code |
622000 |
Sponsor’s telephone number |
5028965000 |
Plan sponsor’s mailing address |
2701 EASTPOINT, LOUISVILLE, KY, 40223 |
Plan sponsor’s
address |
2701 EASTPOINT, LOUISVILLE, KY, 40223 |
Number of participants as of the end of the plan year
Active participants |
424 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2015-07-14 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2015-07-14 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
GROUP LIFE
|
2014
|
610444707
|
2015-07-14
|
BAPTIST HEALTHCARE SYSTEM INC.
|
11494
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2015/07/14/20150714142659P040091469479001.pdf |
Three-digit plan number (PN) |
502 |
Effective date of plan |
1968-04-01 |
Business code |
622000 |
Sponsor’s telephone number |
5028965000 |
Plan sponsor’s mailing address |
2701 EASTPOINT PKWY, LOUISVILLE, KY, 40223 |
Plan sponsor’s
address |
2701 EASTPOINT PKWY, LOUISVILLE, KY, 40223 |
Number of participants as of the end of the plan year
Active participants |
10505 |
Retired or separated participants receiving
benefits |
989 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2015-07-14 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2015-07-14 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BUSINESS TRAVEL ACCIDENT PLAN
|
2014
|
610444707
|
2015-07-15
|
BAPTIST HEALTHCARE SYSTEM
|
325
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2015/07/15/20150715085936P030002050889001.pdf |
Three-digit plan number (PN) |
509 |
Effective date of plan |
1968-04-01 |
Business code |
622000 |
Sponsor’s telephone number |
5028965000 |
Plan sponsor’s mailing address |
2701 EASTPOINT PKWY, LOUISVILLE, KY, 40223 |
Plan sponsor’s
address |
2701 EASTPOINT PKWY, LOUISVILLE, KY, 40223 |
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2015-07-15 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2015-07-15 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
ACCIDENTAL DEATH & DISMEMBERMENT
|
2014
|
610444707
|
2015-07-14
|
BAPTIST HEALTHCARE SYSTEM
|
2396
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2015/07/14/20150714144445P040113313681001.pdf |
Three-digit plan number (PN) |
503 |
Effective date of plan |
1968-04-01 |
Business code |
622000 |
Sponsor’s telephone number |
5028965000 |
Plan sponsor’s mailing address |
2701 EASTPOINT PARKWAY, LOUISVILLE, KY, 40223 |
Plan sponsor’s
address |
2701 EASTPOINT PARKWAY, LOUISVILLE, KY, 40223 |
Number of participants as of the end of the plan year
Active participants |
2396 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2015-07-14 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2015-07-14 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
MANAGEMENT DISABILITY PLAN
|
2014
|
610444707
|
2015-07-14
|
BAPTIST HEALTHCARE SYSTEM
|
320
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2015/07/14/20150714150401P030031377773001.pdf |
Three-digit plan number (PN) |
504 |
Effective date of plan |
2009-01-01 |
Business code |
622000 |
Sponsor’s telephone number |
5028965000 |
Plan sponsor’s mailing address |
2701 EASTPOINT PARKWAY, LOUISVILLE, KY, 40223 |
Plan sponsor’s
address |
2701 EASTPOINT PARKWAY, LOUISVILLE, KY, 40223 |
Number of participants as of the end of the plan year
Active participants |
0 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2015-07-14 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2015-07-14 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
CANCER PLAN
|
2014
|
610444707
|
2015-07-15
|
BAPTIST HEALTHCARE SYSTEM
|
3295
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2015/07/15/20150715101821P030031832685001.pdf |
Three-digit plan number (PN) |
512 |
Effective date of plan |
2010-01-01 |
Business code |
622000 |
Sponsor’s telephone number |
5028965000 |
Plan sponsor’s mailing address |
2701 EASTPOINT PKWY, LOUISVILLE, KY, 40223 |
Plan sponsor’s
address |
2701 EASTPOINT PKWY, LOUISVILLE, KY, 40223 |
Number of participants as of the end of the plan year
Active participants |
0 |
Retired or separated participants receiving
benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2015-07-15 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2015-07-15 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
DENTAL PLAN
|
2014
|
610444707
|
2015-07-15
|
BAPTIST HEALTHCARE SYSTEM
|
20367
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2015/07/15/20150715083834P030031712765001.pdf |
Three-digit plan number (PN) |
506 |
Effective date of plan |
2012-01-01 |
Business code |
622000 |
Sponsor’s telephone number |
5028965000 |
Plan sponsor’s mailing address |
2701 EASTPOINT PARKWAY, LOUISVILLE, KY, 40223 |
Plan sponsor’s
address |
2701 EASTPOINT PARKWAY, LOUISVILLE, KY, 40223 |
Signature of
Role |
Plan administrator |
Date |
2015-07-15 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2015-07-15 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
SEVERANCE PLAN
|
2014
|
610444707
|
2015-07-15
|
BAPTIST HEALTHCARE SYSTEM
|
11494
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2015/07/15/20150715084807P040093066055001.pdf |
Three-digit plan number (PN) |
506 |
Effective date of plan |
1991-03-26 |
Business code |
622000 |
Sponsor’s telephone number |
5028965000 |
Plan sponsor’s mailing address |
2701 EASTPOINT PARKWAY, LOUISVILLE, KY, 40223 |
Plan sponsor’s
address |
2701 EASTPOINT PARKWAY, LOUISVILLE, KY, 40223 |
Signature of
Role |
Plan administrator |
Date |
2015-07-15 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2015-07-15 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
CRITICAL ILLNESS PLAN
|
2014
|
610444707
|
2015-07-15
|
BAPTIST HEALTHCARE SYSTEM
|
798
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2015/07/15/20150715095933P030097927191001.pdf |
Three-digit plan number (PN) |
513 |
Effective date of plan |
2013-01-01 |
Business code |
622000 |
Sponsor’s telephone number |
5028965000 |
Plan sponsor’s mailing address |
2701 EASTPOINT PARKWAY, LOUISVILLE, KY, 40223 |
Plan sponsor’s
address |
2701 EASTPOINT PARKWAY, LOUISVILLE, KY, 40223 |
Number of participants as of the end of the plan year
Active participants |
0 |
Retired or separated participants receiving
benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2015-07-15 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2015-07-15 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
MADISONVILLE HEALTH PLAN
|
2013
|
610444707
|
2015-07-23
|
BAPTIST HEALTHCARE SYSTEM
|
1134
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2015/07/23/20150723102339P030112486647001.pdf |
Three-digit plan number (PN) |
501 |
Effective date of plan |
1994-02-01 |
Business code |
622000 |
Sponsor’s telephone number |
5028965000 |
Plan sponsor’s mailing address |
2701 EASTPOINT PARKWAY, LOUISVILLE, KY, 40223 |
Plan sponsor’s
address |
2701 EASTPOINT PARKWAY, LOUISVILLE, KY, 40223 |
Number of participants as of the end of the plan year
Active participants |
1134 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2015-07-23 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
CANCER PLAN
|
2013
|
610444707
|
2014-07-28
|
BAPTIST HEALTHCARE SYSTEM INC.
|
3404
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2014/07/28/20140728143427P030060629687001.pdf |
Three-digit plan number (PN) |
512 |
Effective date of plan |
2010-01-01 |
Business code |
622000 |
Sponsor’s telephone number |
5028965000 |
Plan
sponsor’s DBA name |
SAME |
Plan sponsor’s mailing address |
2701 EASTPOINT PARKWAY, LOUISVILLE, KY, 40223 |
Plan sponsor’s
address |
2701 EASTPOINT PARKWAY, LOUISVILLE, KY, 40223 |
Number of participants as of the end of the plan year
Active participants |
3404 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2014-07-28 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
MANAGEMENT DISABILITY PLAN
|
2013
|
610444707
|
2014-07-28
|
BAPTIST HEALTHCARE SYSTEM INC.
|
315
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2014/07/28/20140728130745P040003026825001.pdf |
Three-digit plan number (PN) |
504 |
Effective date of plan |
2009-01-01 |
Business code |
622000 |
Sponsor’s telephone number |
5028965000 |
Plan
sponsor’s DBA name |
SAME |
Plan sponsor’s mailing address |
2701 EASTPOINT PARKWAY, LOUISVILLE, KY, 40223 |
Plan sponsor’s
address |
2701 EASTPOINT PARKWAY, LOUISVILLE, KY, 40223 |
Number of participants as of the end of the plan year
Active participants |
315 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2014-07-28 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
DENTAL PLAN
|
2013
|
610444707
|
2014-07-28
|
BAPTIST HEALTHCARE SYSTEM INC.
|
19983
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2014/07/28/20140728134041P040019324399001.pdf |
Three-digit plan number (PN) |
506 |
Effective date of plan |
2012-01-01 |
Business code |
622000 |
Sponsor’s telephone number |
5028965000 |
Plan
sponsor’s DBA name |
SAME |
Plan sponsor’s mailing address |
2701 EASTPOINT PARKWAY, LOUISVILLE, KY, 40223 |
Plan sponsor’s
address |
2701 EASTPOINT PARKWAY, LOUISVILLE, KY, 40223 |
Number of participants as of the end of the plan year
Active participants |
19983 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2014-07-28 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
SHORT TERM DISABILITY PLAN
|
2013
|
610444707
|
2014-07-29
|
BAPTIST HEALTHCARE SYSTEM INC.
|
2475
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2014/07/29/20140729102803P040026306173001.pdf |
Three-digit plan number (PN) |
510 |
Effective date of plan |
1998-01-01 |
Business code |
622000 |
Sponsor’s telephone number |
5028965000 |
Plan
sponsor’s DBA name |
SAME |
Plan sponsor’s mailing address |
2701 EASTPOINT PARKWAY, LOUISVILLE, KY, 40223 |
Plan sponsor’s
address |
2701 EASTPOINT PARKWAY, LOUISVILLE, KY, 40223 |
Number of participants as of the end of the plan year
Active participants |
2475 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2014-07-29 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BUSINESS TRAVEL ACCIDENT
|
2013
|
610444707
|
2014-07-29
|
BAPTIST HEALTHCARE SYSTEM INC.
|
320
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2014/07/29/20140729103410P040061304791001.pdf |
Three-digit plan number (PN) |
509 |
Effective date of plan |
1968-04-01 |
Business code |
622000 |
Sponsor’s telephone number |
5058965000 |
Plan
sponsor’s DBA name |
SAME |
Plan sponsor’s mailing address |
2701 EASTPOINT PARKWAY, LOUISVILLE, KY, 40223 |
Plan sponsor’s
address |
2701 EASTPOINT PARKWAY, LOUISVILLE, KY, 40223 |
Number of participants as of the end of the plan year
Active participants |
320 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2014-07-29 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
CRITICAL ILLNESS PLAN
|
2013
|
610444707
|
2014-07-28
|
BAPTIST HEALTHCARE SYSTEM INC.
|
650
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2014/07/28/20140728150408P040019452047001.pdf |
Three-digit plan number (PN) |
513 |
Effective date of plan |
2013-01-01 |
Business code |
622000 |
Sponsor’s telephone number |
5028965000 |
Plan
sponsor’s DBA name |
SAME |
Plan sponsor’s mailing address |
2701 EASTPOINT PARKWAY, LOUISVILLE, KY, 40223 |
Plan sponsor’s
address |
2701 EASTPOINT PARKWAY, LOUISVILLE, KY, 40223 |
Number of participants as of the end of the plan year
Active participants |
650 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2014-07-28 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BASIC GROUP DISABILITY PLAN
|
2013
|
610444707
|
2014-07-28
|
BAPTIST HEALTHCARE SYSTEM INC.
|
8972
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2014/07/28/20140728132022P030023431805001.pdf |
Three-digit plan number (PN) |
505 |
Effective date of plan |
2009-01-01 |
Business code |
622000 |
Sponsor’s telephone number |
5028965000 |
Plan
sponsor’s DBA name |
SAME |
Plan sponsor’s mailing address |
2701 EASTPOINT PARKWAY, LOUISVILLE, KY, 40223 |
Plan sponsor’s
address |
2701 EASTPOINT PARKWAY, LOUISVILLE, KY, 40223 |
Number of participants as of the end of the plan year
Active participants |
8972 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2014-07-28 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
SEVERANCE PLAN
|
2013
|
610444707
|
2014-07-28
|
BAPTIST HEALTHCARE SYSTEM INC.
|
12444
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2014/07/28/20140728135031P030023459789001.pdf |
Three-digit plan number (PN) |
508 |
Effective date of plan |
1991-03-26 |
Business code |
622000 |
Sponsor’s telephone number |
5028965000 |
Plan
sponsor’s DBA name |
SAME |
Plan sponsor’s mailing address |
2701 EASTPOINT PARKWAY, LOUISVILLE, KY, 40223 |
Plan sponsor’s
address |
2701 EASTPOINT PARKWAY, LOUISVILLE, KY, 40223 |
Number of participants as of the end of the plan year
Active participants |
12444 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2014-07-28 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BAPTIST LEXINGTON HEALTH PLAN
|
2013
|
610444707
|
2014-07-29
|
BAPTIST HEALTHCARE SYSTEM INC.
|
2668
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2014/07/29/20140729151303P040026482461001.pdf |
Three-digit plan number (PN) |
516 |
Effective date of plan |
2013-01-01 |
Business code |
622000 |
Sponsor’s telephone number |
5028965051 |
Plan
sponsor’s DBA name |
BAPTIST HEALTH LEXINGTON |
Plan sponsor’s mailing address |
2701 EASTPOINT PARKWAY, LOUISVILLE, KY, 40223 |
Plan sponsor’s
address |
2701 EASTPOINT PARKWAY, LOUISVILLE, KY, 40223 |
Number of participants as of the end of the plan year
Active participants |
2654 |
Retired or separated participants receiving
benefits |
14 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2014-07-29 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BRMC HEALTH PLAN
|
2013
|
311593064
|
2014-07-29
|
BAPTIST HEALTHCARE SYSTEM INC.
|
1168
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2014/07/29/20140729145515P030020219327001.pdf |
Three-digit plan number (PN) |
501 |
Effective date of plan |
2013-01-01 |
Business code |
622000 |
Sponsor’s telephone number |
5028965000 |
Plan
sponsor’s DBA name |
BAPTIST REGIONAL MEDICAL CENTER |
Plan sponsor’s mailing address |
2701 EASTPOINT PARKWAY, LOUISVILLE, KY, 40223 |
Plan sponsor’s
address |
2701 EASTPOINT PARKWAY, LOUISVILLE, KY, 40223 |
Number of participants as of the end of the plan year
Active participants |
1160 |
Retired or separated participants receiving
benefits |
8 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2014-07-29 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BAPTIST RICHMOND HEALTH PLAN
|
2013
|
610444707
|
2014-07-29
|
BAPTIST HEALTHCARE SYSTEM INC.
|
431
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2014/07/29/20140729153541P040026496141001.pdf |
Three-digit plan number (PN) |
515 |
Effective date of plan |
2012-01-01 |
Business code |
622000 |
Sponsor’s telephone number |
5058965000 |
Plan
sponsor’s DBA name |
BAPTIST HEALTH RICHMOND |
Plan sponsor’s mailing address |
2701 EASTPOINT PARKWAY, LOUISVILLE, KY, 40223 |
Plan sponsor’s
address |
2701 EASTPOINT PARKWAY, LOUISVILLE, KY, 40223 |
Number of participants as of the end of the plan year
Active participants |
431 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2014-07-29 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
HEALTH PLAN
|
2013
|
610444707
|
2014-07-29
|
BAPTIST HEALTHCARE SYSTEM INC.
|
5566
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2014/07/29/20140729144315P030062552423001.pdf |
Three-digit plan number (PN) |
501 |
Effective date of plan |
1983-03-01 |
Business code |
622000 |
Sponsor’s telephone number |
5028965000 |
Plan
sponsor’s DBA name |
SAME |
Plan sponsor’s mailing address |
2701 EASTPOINT PARKWAY, LOUISVILLE, KY, 40223 |
Plan sponsor’s
address |
2701 EASTPOINT PARKWAY, LOUISVILLE, KY, 40223 |
Number of participants as of the end of the plan year
Active participants |
5482 |
Retired or separated participants receiving
benefits |
84 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2014-07-29 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
GROUP LIFE
|
2013
|
610444707
|
2014-07-23
|
BAPTIST HEALTHCARE SYSTEM INC.
|
12008
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2014/07/23/20140723125706P040052260439001.pdf |
Three-digit plan number (PN) |
502 |
Effective date of plan |
1968-04-01 |
Business code |
622000 |
Sponsor’s telephone number |
5028965000 |
Plan
sponsor’s DBA name |
SAME |
Plan sponsor’s mailing address |
2701 EASTPOINT PARKWAY, LOUISVILLE, KY, 40223 |
Plan sponsor’s
address |
2701 EASTPOINT PARKWAY, LOUISVILLE, KY, 40223 |
Number of participants as of the end of the plan year
Active participants |
11033 |
Retired or separated participants receiving
benefits |
975 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2014-07-23 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
ACCIDENTAL DEATH & DISMEMBERMENT
|
2013
|
610444707
|
2014-07-23
|
BAPTIST HEALTHCARE SYSTEM INC.
|
12637
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2014/07/23/20140723144430P030053188231001.pdf |
Three-digit plan number (PN) |
503 |
Effective date of plan |
1968-04-01 |
Business code |
622000 |
Sponsor’s telephone number |
5028965000 |
Plan
sponsor’s DBA name |
SAME |
Plan sponsor’s mailing address |
2701 EASTPOINT PARKWAY, LOUISVILLE, KY, 40223 |
Plan sponsor’s
address |
2701 EASTPOINT PARKWAY, LOUISVILLE, KY, 40223 |
Number of participants as of the end of the plan year
Active participants |
12637 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2014-07-23 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BAPTIST HEALTHCARE SYSTEM, INC. THRIFT PLAN
|
2012
|
610444707
|
2013-10-15
|
BAPTIST HEALTHCARE SYSTEM, INC.
|
12419
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2013/10/15/20131015110400P040015013861001.pdf |
Three-digit plan number (PN) |
003 |
Effective date of plan |
1993-06-01 |
Business code |
622000 |
Sponsor’s telephone number |
5028965050 |
Plan sponsor’s mailing address |
2701 EASTPOINT PARKWAY, LOUISVILLE, KY, 40223 |
Plan sponsor’s
address |
2701 EASTPOINT PARKWAY, LOUISVILLE, KY, 40223 |
Plan administrator’s name and address
Administrator’s EIN |
610444707 |
Plan administrator’s name |
BAPTIST HEALTHCARE SYSTEM, INC. |
Plan administrator’s
address |
2701 EASTPOINT PARKWAY, LOUISVILLE, KY, 40223 |
Administrator’s telephone number |
5028965050 |
Number of participants as of the end of the plan year
Active participants |
11933 |
Retired or separated participants receiving
benefits |
40 |
Other
retired or separated participants entitled to future benefits |
961 |
Deceased participants
whose
beneficiaries are receiving or are entitled to receive benefits |
8 |
Number of
participants
with
account balances as of the end of the plan year |
10360 |
Number of participants that
terminated
employment during the plan year with accrued benefits that were less than 100%
vested |
242 |
Signature of
Role |
Plan administrator |
Date |
2013-10-15 |
Name of individual signing |
MICHAEL DAUGHERTY |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2013-10-15 |
Name of individual signing |
MICHAEL DAUGHERTY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BAPTIST HEALTHCARE SYSTEM, INC. RETIREMENT ACCUMULATION PLAN
|
2012
|
610444707
|
2013-10-15
|
BAPTIST HEALTHCARE SYSTEM, INC.
|
12632
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2013/10/15/20131015110811P040002267680001.pdf |
Three-digit plan number (PN) |
002 |
Effective date of plan |
1993-03-01 |
Business code |
622000 |
Sponsor’s telephone number |
5028965050 |
Plan sponsor’s mailing address |
2701 EASTPOINT PARKWAY, LOUISVILLE, KY, 40223 |
Plan sponsor’s
address |
2701 EASTPOINT PARKWAY, LOUISVILLE, KY, 40223 |
Plan administrator’s name and address
Administrator’s EIN |
610444707 |
Plan administrator’s name |
BAPTIST HEALTHCARE SYSTEM, INC. |
Plan administrator’s
address |
2701 EASTPOINT PARKWAY, LOUISVILLE, KY, 40223 |
Administrator’s telephone number |
5028965050 |
Number of participants as of the end of the plan year
Active participants |
11988 |
Retired or separated participants receiving
benefits |
35 |
Other
retired or separated participants entitled to future benefits |
975 |
Deceased participants
whose
beneficiaries are receiving or are entitled to receive benefits |
13 |
Number of
participants
with
account balances as of the end of the plan year |
9303 |
Number of participants that
terminated
employment during the plan year with accrued benefits that were less than 100%
vested |
221 |
Signature of
Role |
Plan administrator |
Date |
2013-10-15 |
Name of individual signing |
MICHAEL DAUGHERTY |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2013-10-15 |
Name of individual signing |
MICHAEL DAUGHERTY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BHS HEALTH PLAN
|
2012
|
610444707
|
2013-07-15
|
BAPTIST HEALTHCARE SYSTEM INC.
|
5444
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2013/07/15/20130715103532P040304339891001.pdf |
Three-digit plan number (PN) |
501 |
Effective date of plan |
1983-03-01 |
Business code |
622000 |
Sponsor’s telephone number |
5028965000 |
Plan
sponsor’s DBA name |
SAME |
Plan sponsor’s mailing address |
2701 EASTPOINT PARKWAY, LOUISVILLE, KY, 40223 |
Plan sponsor’s
address |
2701 EASTPOINT PARKWAY, LOUISVILLE, KY, 40223 |
Number of participants as of the end of the plan year
Active participants |
5346 |
Retired or separated participants receiving
benefits |
98 |
Signature of
Role |
Plan administrator |
Date |
2013-07-15 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
CANCER PLAN
|
2012
|
610444707
|
2013-07-11
|
BAPTIST HEALTHCARE SYSTEM INC.
|
3465
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2013/07/11/20130711144346P040107852437001.pdf |
Three-digit plan number (PN) |
512 |
Effective date of plan |
2010-01-01 |
Business code |
622000 |
Sponsor’s telephone number |
5028965000 |
Plan
sponsor’s DBA name |
SAME |
Plan sponsor’s mailing address |
2701 EASTPOINT PARKWAY, LOUISVILLE, KY, 40223 |
Plan sponsor’s
address |
2701 EASTPOINT PARKWAY, LOUISVILLE, KY, 40223 |
Number of participants as of the end of the plan year
Active participants |
3465 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2013-07-11 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BUSINESS TRAVEL ACCIDENT
|
2012
|
610444707
|
2013-07-11
|
BAPTIST HEALTHCARE SYSTEM INC.
|
225
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2013/07/11/20130711141156P040038916919001.pdf |
Three-digit plan number (PN) |
509 |
Effective date of plan |
1968-04-01 |
Business code |
622000 |
Sponsor’s telephone number |
5028965000 |
Plan
sponsor’s DBA name |
SAME |
Plan sponsor’s mailing address |
2701 EASTPOINT PARKWAY, LOUISVILLE, KY, 40223 |
Plan sponsor’s
address |
2701 EASTPOINT PARKWAY, LOUISVILLE, KY, 40223 |
Number of participants as of the end of the plan year
Active participants |
225 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2013-07-11 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
DENTAL PLAN
|
2012
|
610444707
|
2013-07-11
|
BAPTIST HEALTHCARE SYSTEM INC.
|
7963
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2013/07/11/20130711135138P030292918931001.pdf |
Three-digit plan number (PN) |
506 |
Effective date of plan |
2012-01-01 |
Business code |
622000 |
Sponsor’s telephone number |
5028965000 |
Plan
sponsor’s DBA name |
SAME |
Plan sponsor’s mailing address |
2701 EASTPOINT PARKWAY, LOUISVILLE, KY, 40223 |
Plan sponsor’s
address |
2701 EASTPOINT PARKWAY, LOUISVILLE, KY, 40223 |
Number of participants as of the end of the plan year
Active participants |
7963 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2013-07-11 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
SEVERANCE PLAN
|
2012
|
610444707
|
2013-07-11
|
BAPTIST HEALTHCARE SYSTEM INC.
|
12008
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2013/07/11/20130711140407P030107543061001.pdf |
Three-digit plan number (PN) |
508 |
Effective date of plan |
1991-03-26 |
Business code |
622000 |
Sponsor’s telephone number |
5028965000 |
Plan
sponsor’s DBA name |
SAME |
Plan sponsor’s mailing address |
2701 EASTPOINT PARKWAY, LOUISVILLE, KY, 40223 |
Plan sponsor’s
address |
2701 EASTPOINT PARKWAY, LOUISVILLE, KY, 40223 |
Number of participants as of the end of the plan year
Active participants |
12008 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2013-07-11 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
LONG TERM DISABILITY PLAN
|
2012
|
610444707
|
2013-07-11
|
BAPTIST HEALTHCARE SYSTEM INC.
|
8797
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2013/07/11/20130711132208P040379785185001.pdf |
Three-digit plan number (PN) |
505 |
Effective date of plan |
2009-01-01 |
Business code |
622000 |
Sponsor’s telephone number |
5028965000 |
Plan
sponsor’s DBA name |
SAME |
Plan sponsor’s mailing address |
2701 EASTPOINT PARKWAY, LOUISVILLE, KY, 40223 |
Plan sponsor’s
address |
2701 EASTPOINT PARKWAY, LOUISVILLE, KY, 40223 |
Number of participants as of the end of the plan year
Active participants |
8797 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2013-07-11 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
VISION PLAN
|
2012
|
610444707
|
2013-07-11
|
BAPTIST HEALTHCARE SYSTEM INC.
|
5731
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2013/07/11/20130711142813P030107560405001.pdf |
Three-digit plan number (PN) |
511 |
Effective date of plan |
2009-01-01 |
Business code |
622000 |
Sponsor’s telephone number |
5028965000 |
Plan
sponsor’s DBA name |
SAME |
Plan sponsor’s mailing address |
2701 EASTPOINT PARKWAY, LOUISVILLE, KY, 40223 |
Plan sponsor’s
address |
2701 EASTPOINT PARKWAY, LOUISVILLE, KY, 40223 |
Number of participants as of the end of the plan year
Active participants |
5731 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2013-07-11 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
ACCIDENTAL DEATH & DISMEMBERMENT
|
2012
|
610444707
|
2013-07-11
|
BAPTIST HEALTHCARE SYSTEM INC.
|
13490
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2013/07/11/20130711102000P040379495313001.pdf |
Three-digit plan number (PN) |
503 |
Effective date of plan |
1968-04-01 |
Business code |
622000 |
Sponsor’s telephone number |
5028965000 |
Plan
sponsor’s DBA name |
SAME |
Plan sponsor’s mailing address |
2701 EASTPOINT PARKWAY, LOUISVILLE, KY, 40223 |
Plan sponsor’s
address |
2701 EASTPOINT PARKWAY, LOUISVILLE, KY, 40223 |
Plan administrator’s name and address
Administrator’s EIN |
610444707 |
Plan administrator’s name |
BAPTIST HEALTHCARE SYSTEM INC. |
Administrator’s telephone number |
5028965000 |
Number of participants as of the end of the plan year
Active participants |
12515 |
Retired or separated participants receiving
benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2013-07-11 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
GROUP LIFE PLAN
|
2012
|
610444707
|
2013-07-11
|
BAPTIST HEALTHCARE SYSTEM INC.
|
12515
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2013/07/11/20130711092059P030292600083001.pdf |
Three-digit plan number (PN) |
502 |
Effective date of plan |
1968-04-01 |
Business code |
622000 |
Sponsor’s telephone number |
5028965000 |
Plan
sponsor’s DBA name |
SAME |
Plan sponsor’s mailing address |
2701 EASTPOINT PARKWAY, LOUISVILLE, KY, 40223 |
Plan sponsor’s
address |
2701 EASTPOINT PARKWAY, LOUISVILLE, KY, 40223 |
Number of participants as of the end of the plan year
Active participants |
12515 |
Retired or separated participants receiving
benefits |
975 |
Signature of
Role |
Plan administrator |
Date |
2013-07-11 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
MGMT DISABILITY PLAN
|
2012
|
610444707
|
2013-07-11
|
BAPTIST HEALTHCARE SYSTEM INC.
|
215
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2013/07/11/20130711122625P040299025859001.pdf |
Three-digit plan number (PN) |
504 |
Effective date of plan |
2009-01-01 |
Business code |
622000 |
Sponsor’s telephone number |
5028965000 |
Plan
sponsor’s DBA name |
SAME |
Plan sponsor’s mailing address |
2701 EASTPOINT PARKWAY, LOUISVILLE, KY, 40223 |
Plan sponsor’s
address |
2701 EASTPOINT PARKWAY, LOUISVILLE, KY, 40223 |
Number of participants as of the end of the plan year
Active participants |
215 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2013-07-11 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
SHORT TERM DISABILITY PLAN
|
2012
|
610444707
|
2013-07-12
|
BAPTIST HEALTHCARE SYSTEM INC.
|
2435
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2013/07/12/20130712101356P030108195333001.pdf |
Three-digit plan number (PN) |
510 |
Effective date of plan |
1998-01-01 |
Business code |
622000 |
Sponsor’s telephone number |
5028965000 |
Plan
sponsor’s DBA name |
SAME |
Plan sponsor’s mailing address |
2701 EASTPOINT PARKWAY, LOUISVILLE, KY, 40223 |
Plan sponsor’s
address |
2701 EASTPOINT PARKWAY, LOUISVILLE, KY, 40223 |
Number of participants as of the end of the plan year
Active participants |
2435 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2013-07-12 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BAPTIST HEALTHCARE SYSTEM, INC. RETIREMENT ACCUMULATION PLAN
|
2011
|
610444707
|
2012-10-15
|
BAPTIST HEALTHCARE SYSTEM, INC.
|
12096
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2012/10/15/20121015111127P030007394033001.pdf |
Three-digit plan number (PN) |
002 |
Effective date of plan |
1993-03-01 |
Business code |
622000 |
Sponsor’s telephone number |
5028965050 |
Plan sponsor’s mailing address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Plan sponsor’s
address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Plan administrator’s name and address
Administrator’s EIN |
610444707 |
Plan administrator’s name |
BAPTIST HEALTHCARE SYSTEM, INC. |
Plan administrator’s
address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Administrator’s telephone number |
5028965050 |
Number of participants as of the end of the plan year
Active participants |
11562 |
Retired or separated participants receiving
benefits |
42 |
Other
retired or separated participants entitled to future benefits |
1015 |
Deceased participants
whose
beneficiaries are receiving or are entitled to receive benefits |
13 |
Number of
participants
with
account balances as of the end of the plan year |
9278 |
Number of participants that
terminated
employment during the plan year with accrued benefits that were less than 100%
vested |
277 |
Signature of
Role |
Plan administrator |
Date |
2012-10-15 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BAPTIST HEALTHCARE SYSTEM, INC. THRIFT PLAN
|
2011
|
610444707
|
2012-10-15
|
BAPTIST HEALTHCARE SYSTEM, INC.
|
11882
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2012/10/15/20121015092332P030016528466001.pdf |
Three-digit plan number (PN) |
003 |
Effective date of plan |
1993-06-01 |
Business code |
622000 |
Sponsor’s telephone number |
5028965050 |
Plan sponsor’s mailing address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Plan sponsor’s
address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Plan administrator’s name and address
Administrator’s EIN |
610444707 |
Plan administrator’s name |
BAPTIST HEALTHCARE SYSTEM, INC. |
Plan administrator’s
address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Administrator’s telephone number |
5028965050 |
Number of participants as of the end of the plan year
Active participants |
11397 |
Retired or separated participants receiving
benefits |
43 |
Other
retired or separated participants entitled to future benefits |
973 |
Deceased participants
whose
beneficiaries are receiving or are entitled to receive benefits |
6 |
Number of
participants
with
account balances as of the end of the plan year |
9539 |
Number of participants that
terminated
employment during the plan year with accrued benefits that were less than 100%
vested |
258 |
Signature of
Role |
Plan administrator |
Date |
2012-10-15 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BRMC HEALTH PLAN
|
2011
|
311593064
|
2012-07-16
|
BAPTIST HEALTHCARE SYSTEM INC.
|
967
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2012/07/16/20120716091328P040004250466001.pdf |
Three-digit plan number (PN) |
502 |
Effective date of plan |
1997-01-01 |
Business code |
622000 |
Sponsor’s telephone number |
5028965000 |
Plan
sponsor’s DBA name |
BAPTIST REGIONAL MEDICAL CENTER |
Plan sponsor’s mailing address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Plan sponsor’s
address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Plan administrator’s name and address
Administrator’s EIN |
311593064 |
Plan administrator’s name |
BAPTIST HEALTHCARE SYSTEM INC. |
Plan administrator’s
address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Administrator’s telephone number |
5028965000 |
Number of participants as of the end of the plan year
Active participants |
967 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2012-07-16 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
CANCER PLAN
|
2011
|
610444707
|
2012-07-14
|
BAPTIST HEALTHCARE SYSTEM INC.
|
3519
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2012/07/14/20120714171716P040003237522001.pdf |
Three-digit plan number (PN) |
512 |
Effective date of plan |
2010-01-01 |
Business code |
622000 |
Sponsor’s telephone number |
5028965000 |
Plan
sponsor’s DBA name |
SAME |
Plan sponsor’s mailing address |
4007 KRESGE WAY, 4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Plan sponsor’s
address |
4007 KRESGE WAY, 4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Plan administrator’s name and address
Administrator’s EIN |
610444707 |
Plan administrator’s name |
BAPTIST HEALTHCARE SYSTEM INC. |
Plan administrator’s
address |
4007 KRESGE WAY, 4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Administrator’s telephone number |
5028965000 |
Number of participants as of the end of the plan year
Active participants |
3519 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2012-07-14 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
VISION PLAN
|
2011
|
610444707
|
2012-07-14
|
BAPTIST HEALTHCARE SYSTEM, INC.
|
11090
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2012/07/14/20120714170106P030010204288001.pdf |
Three-digit plan number (PN) |
511 |
Effective date of plan |
2010-01-01 |
Business code |
622000 |
Sponsor’s telephone number |
5028965000 |
Plan
sponsor’s DBA name |
SAME |
Plan sponsor’s mailing address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Plan sponsor’s
address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Plan administrator’s name and address
Administrator’s EIN |
610444707 |
Plan administrator’s name |
BAPTIST HEALTHCARE SYSTEM, INC. |
Plan administrator’s
address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Administrator’s telephone number |
5028965000 |
Number of participants as of the end of the plan year
Active participants |
11090 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2012-07-14 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
SHORT TERM DISABILITY PLAN
|
2011
|
610444707
|
2012-07-14
|
BAPTIST HEALTHCARE SYSTEM INC.
|
2391
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2012/07/14/20120714164513P030010177312001.pdf |
Three-digit plan number (PN) |
510 |
Effective date of plan |
1993-01-01 |
Business code |
622000 |
Sponsor’s telephone number |
5028965000 |
Plan
sponsor’s DBA name |
SAME |
Plan sponsor’s mailing address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Plan sponsor’s
address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Plan administrator’s name and address
Administrator’s EIN |
610444707 |
Plan administrator’s name |
BAPTIST HEALTHCARE SYSTEM INC. |
Plan administrator’s
address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Administrator’s telephone number |
5028965000 |
Number of participants as of the end of the plan year
Active participants |
2391 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2012-07-14 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BUSINESS TRAVEL ACCIDENT
|
2011
|
610444707
|
2012-07-14
|
BAPTIST HEALTHCARE SYSTEM
|
211
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2012/07/14/20120714162516P040003215602001.pdf |
Three-digit plan number (PN) |
509 |
Effective date of plan |
1968-04-01 |
Business code |
622000 |
Sponsor’s telephone number |
5028965000 |
Plan
sponsor’s DBA name |
SAME |
Plan sponsor’s mailing address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Plan sponsor’s
address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Plan administrator’s name and address
Administrator’s EIN |
610444707 |
Plan administrator’s name |
BAPTIST HEALTHCARE SYSTEM |
Plan administrator’s
address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Administrator’s telephone number |
5028965000 |
Number of participants as of the end of the plan year
Active participants |
211 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2012-07-14 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
SEVERANCE PLAN
|
2011
|
610444707
|
2012-07-14
|
BAPTIST HEALTHCARE SYSTEM
|
11444
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2012/07/14/20120714161948P030001577905001.pdf |
Three-digit plan number (PN) |
508 |
Effective date of plan |
1991-03-26 |
Business code |
622000 |
Sponsor’s telephone number |
5028965000 |
Plan
sponsor’s DBA name |
SAME |
Plan sponsor’s mailing address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Plan sponsor’s
address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Plan administrator’s name and address
Administrator’s EIN |
610444707 |
Plan administrator’s name |
BAPTIST HEALTHCARE SYSTEM |
Plan administrator’s
address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Administrator’s telephone number |
5028965000 |
Number of participants as of the end of the plan year
Active participants |
11444 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2012-07-14 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
DENTAL PLAN
|
2011
|
610444707
|
2012-07-14
|
BAPTIST HEALTHCARE SYSTEM INC.
|
7204
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2012/07/14/20120714161240P040003210338001.pdf |
Three-digit plan number (PN) |
506 |
Effective date of plan |
1989-01-01 |
Business code |
622000 |
Sponsor’s telephone number |
5028965000 |
Plan
sponsor’s DBA name |
SAME |
Plan sponsor’s mailing address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Plan sponsor’s
address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Plan administrator’s name and address
Administrator’s EIN |
610444707 |
Plan administrator’s name |
BAPTIST HEALTHCARE SYSTEM INC. |
Plan administrator’s
address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Administrator’s telephone number |
5028965000 |
Number of participants as of the end of the plan year
Active participants |
7204 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2012-07-14 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
GROUP DISABILITY PLAN
|
2011
|
610444707
|
2012-07-14
|
BAPTIST HEALTHCARE SYSTEM
|
8252
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2012/07/14/20120714155217P030010092656001.pdf |
Three-digit plan number (PN) |
505 |
Effective date of plan |
1989-01-01 |
Business code |
622000 |
Plan
sponsor’s DBA name |
SAME |
Plan sponsor’s mailing address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Plan sponsor’s
address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Plan administrator’s name and address
Administrator’s EIN |
610444707 |
Plan administrator’s name |
BAPTIST HEALTHCARE SYSTEM |
Plan administrator’s
address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Number of participants as of the end of the plan year
Active participants |
8252 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2012-07-14 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
MANAGEMENT DISABILITY PLAN
|
2011
|
610444707
|
2012-07-14
|
BAPTIST HEALTHCARE SYSTEM INC.
|
220
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2012/07/14/20120714154238P040003197426001.pdf |
Three-digit plan number (PN) |
504 |
Effective date of plan |
1979-09-01 |
Business code |
622000 |
Plan
sponsor’s DBA name |
SAME |
Plan sponsor’s mailing address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Plan sponsor’s
address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Plan administrator’s name and address
Administrator’s EIN |
610444707 |
Plan administrator’s name |
BAPTIST HEALTHCARE SYSTEM INC. |
Plan administrator’s
address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Number of participants as of the end of the plan year
Active participants |
220 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2012-07-14 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
GROUP ACCIDENTAL DEATH & DISMEMBERMENT
|
2011
|
610444707
|
2012-07-14
|
BAPTIST HEALTHCARE SYSTEM INC.
|
10482
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2012/07/14/20120714152429P040003194466001.pdf |
Three-digit plan number (PN) |
503 |
Effective date of plan |
1968-04-01 |
Business code |
622000 |
Plan
sponsor’s DBA name |
SAME |
Plan sponsor’s mailing address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Plan sponsor’s
address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Plan administrator’s name and address
Administrator’s EIN |
610444707 |
Plan administrator’s name |
BAPTIST HEALTHCARE SYSTEM INC. |
Plan administrator’s
address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Number of participants as of the end of the plan year
Active participants |
10482 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2012-07-14 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
GROUP LIFE INSURANCE
|
2011
|
610444707
|
2012-07-14
|
BAPTIST HEALTHCARE SYSTEM, INC.
|
11444
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2012/07/14/20120714150546P040003187778001.pdf |
Three-digit plan number (PN) |
502 |
Effective date of plan |
1968-04-01 |
Business code |
622000 |
Plan
sponsor’s DBA name |
SAME |
Plan sponsor’s mailing address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Plan sponsor’s
address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Plan administrator’s name and address
Administrator’s EIN |
610444707 |
Plan administrator’s name |
BAPTIST HEALTHCARE SYSTEM, INC. |
Plan administrator’s
address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Number of participants as of the end of the plan year
Active participants |
11444 |
Retired or separated participants receiving
benefits |
966 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2012-07-14 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BHS HEALTH PLAN
|
2011
|
610444707
|
2012-07-16
|
BAPTIST HEALTHCARE SYSTEM INC.
|
4995
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2012/07/16/20120716142113P030005704690001.pdf |
Three-digit plan number (PN) |
501 |
Effective date of plan |
1983-03-01 |
Business code |
622000 |
Sponsor’s telephone number |
5028965000 |
Plan
sponsor’s DBA name |
SAME |
Plan sponsor’s mailing address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Plan sponsor’s
address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Plan administrator’s name and address
Administrator’s EIN |
610444707 |
Plan administrator’s name |
BAPTIST HEALTHCARE SYSTEM INC. |
Plan administrator’s
address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Administrator’s telephone number |
5028965000 |
Number of participants as of the end of the plan year
Active participants |
4995 |
Retired or separated participants receiving
benefits |
150 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2012-07-16 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BAPTIST HEALTHCARE SYSTEM, INC. THRIFT PLAN
|
2010
|
610444707
|
2011-10-17
|
BAPTIST HEALTHCARE SYSTEM, INC.
|
11443
|
|
Three-digit plan number (PN) |
003 |
Effective date of plan |
1993-06-01 |
Business code |
622000 |
Sponsor’s telephone number |
5028965050 |
Plan sponsor’s mailing address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Plan sponsor’s
address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Plan administrator’s name and address
Administrator’s EIN |
610444707 |
Plan administrator’s name |
BAPTIST HEALTHCARE SYSTEM, INC. |
Plan administrator’s
address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Administrator’s telephone number |
5028965050 |
Number of participants as of the end of the plan year
Active participants |
10992 |
Retired or separated participants receiving
benefits |
39 |
Other
retired or separated participants entitled to future benefits |
847 |
Deceased participants
whose
beneficiaries are receiving or are entitled to receive benefits |
4 |
Number of
participants
with
account balances as of the end of the plan year |
8832 |
Number of participants that
terminated
employment during the plan year with accrued benefits that were less than 100%
vested |
201 |
Signature of
Role |
Employer/plan sponsor |
Date |
2011-10-17 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BAPTIST HEALTHCARE SYSTEM, INC. THRIFT PLAN
|
2010
|
610444707
|
2011-10-17
|
BAPTIST HEALTHCARE SYSTEM, INC.
|
11443
|
|
Three-digit plan number (PN) |
003 |
Effective date of plan |
1993-06-01 |
Business code |
622000 |
Sponsor’s telephone number |
5028965050 |
Plan sponsor’s mailing address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Plan sponsor’s
address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Plan administrator’s name and address
Administrator’s EIN |
610444707 |
Plan administrator’s name |
BAPTIST HEALTHCARE SYSTEM, INC. |
Plan administrator’s
address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Administrator’s telephone number |
5028965050 |
Number of participants as of the end of the plan year
Active participants |
10992 |
Retired or separated participants receiving
benefits |
39 |
Other
retired or separated participants entitled to future benefits |
847 |
Deceased participants
whose
beneficiaries are receiving or are entitled to receive benefits |
4 |
Number of
participants
with
account balances as of the end of the plan year |
8832 |
Number of participants that
terminated
employment during the plan year with accrued benefits that were less than 100%
vested |
201 |
Signature of
Role |
Plan administrator |
Date |
2011-10-17 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BAPTIST HEALTHCARE SYSTEM, INC. THRIFT PLAN
|
2010
|
610444707
|
2011-10-17
|
BAPTIST HEALTHCARE SYSTEM, INC.
|
11443
|
|
Three-digit plan number (PN) |
003 |
Effective date of plan |
1993-06-01 |
Business code |
622000 |
Sponsor’s telephone number |
5028965050 |
Plan sponsor’s mailing address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Plan sponsor’s
address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Plan administrator’s name and address
Administrator’s EIN |
610444707 |
Plan administrator’s name |
BAPTIST HEALTHCARE SYSTEM, INC. |
Plan administrator’s
address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Administrator’s telephone number |
5028965050 |
Number of participants as of the end of the plan year
Active participants |
10992 |
Retired or separated participants receiving
benefits |
39 |
Other
retired or separated participants entitled to future benefits |
847 |
Deceased participants
whose
beneficiaries are receiving or are entitled to receive benefits |
4 |
Number of
participants
with
account balances as of the end of the plan year |
8832 |
Number of participants that
terminated
employment during the plan year with accrued benefits that were less than 100%
vested |
201 |
Signature of
Role |
Plan administrator |
Date |
2011-10-17 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BAPTIST HEALTHCARE SYSTEM, INC. THRIFT PLAN
|
2010
|
610444707
|
2011-10-17
|
BAPTIST HEALTHCARE SYSTEM, INC.
|
11443
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2011/10/17/20111017141325P040154976529001.pdf |
Three-digit plan number (PN) |
003 |
Effective date of plan |
1993-06-01 |
Business code |
622000 |
Sponsor’s telephone number |
5028965050 |
Plan sponsor’s mailing address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Plan sponsor’s
address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Plan administrator’s name and address
Administrator’s EIN |
610444707 |
Plan administrator’s name |
BAPTIST HEALTHCARE SYSTEM, INC. |
Plan administrator’s
address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Administrator’s telephone number |
5028965050 |
Number of participants as of the end of the plan year
Active participants |
10992 |
Retired or separated participants receiving
benefits |
39 |
Other
retired or separated participants entitled to future benefits |
847 |
Deceased participants
whose
beneficiaries are receiving or are entitled to receive benefits |
4 |
Number of
participants
with
account balances as of the end of the plan year |
8832 |
Number of participants that
terminated
employment during the plan year with accrued benefits that were less than 100%
vested |
201 |
Signature of
Role |
Plan administrator |
Date |
2011-10-17 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BAPTIST HEALTHCARE SYSTEM, INC. RETIREMENT ACCUMULATION PLAN
|
2010
|
610444707
|
2011-10-17
|
BAPTIST HEALTHCARE SYSTEM, INC.
|
11087
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2011/10/17/20111017140814P040154971713001.pdf |
Three-digit plan number (PN) |
002 |
Effective date of plan |
1993-03-01 |
Business code |
622000 |
Sponsor’s telephone number |
5028965050 |
Plan sponsor’s mailing address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Plan sponsor’s
address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Plan administrator’s name and address
Administrator’s EIN |
610444707 |
Plan administrator’s name |
BAPTIST HEALTHCARE SYSTEM, INC. |
Plan administrator’s
address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Administrator’s telephone number |
5028965050 |
Number of participants as of the end of the plan year
Active participants |
10132 |
Retired or separated participants receiving
benefits |
44 |
Other
retired or separated participants entitled to future benefits |
1915 |
Deceased participants
whose
beneficiaries are receiving or are entitled to receive benefits |
5 |
Number of
participants
with
account balances as of the end of the plan year |
9002 |
Number of participants that
terminated
employment during the plan year with accrued benefits that were less than 100%
vested |
266 |
Signature of
Role |
Plan administrator |
Date |
2011-10-17 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
DENTAL PLAN
|
2010
|
610444707
|
2011-07-26
|
BAPTIST HEALTHCARE SYSTEM INC.
|
8099
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2011/07/26/20110726101318P040103578177001.pdf |
Three-digit plan number (PN) |
506 |
Effective date of plan |
1989-01-01 |
Business code |
622000 |
Sponsor’s telephone number |
5028965000 |
Plan
sponsor’s DBA name |
SAME |
Plan sponsor’s mailing address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Plan sponsor’s
address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Plan administrator’s name and address
Administrator’s EIN |
610444707 |
Plan administrator’s name |
BAPTIST HEALTHCARE SYSTEM INC. |
Plan administrator’s
address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Administrator’s telephone number |
5028965000 |
Number of participants as of the end of the plan year
Active participants |
8099 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2011-07-26 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
CANCER PLAN
|
2010
|
610444707
|
2011-07-26
|
BAPTIST HEALTHCARE SYSTEM INC.
|
3519
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2011/07/26/20110726151251P040032538359001.pdf |
Three-digit plan number (PN) |
512 |
Effective date of plan |
2010-01-01 |
Business code |
622000 |
Sponsor’s telephone number |
5028965000 |
Plan
sponsor’s DBA name |
SAME |
Plan sponsor’s mailing address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Plan sponsor’s
address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Plan administrator’s name and address
Administrator’s EIN |
610444707 |
Plan administrator’s name |
BAPTIST HEALTHCARE SYSTEM INC. |
Plan administrator’s
address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Administrator’s telephone number |
5028965000 |
Number of participants as of the end of the plan year
Active participants |
3519 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2011-07-26 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BUSINESS TRAVEL ACCIDENT
|
2010
|
610444707
|
2011-07-26
|
BAPTIST HEALTHCARE SYSTEM, INC.
|
220
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2011/07/26/20110726140137P040468488496001.pdf |
Three-digit plan number (PN) |
509 |
Effective date of plan |
1968-04-01 |
Business code |
622000 |
Sponsor’s telephone number |
5028965000 |
Plan
sponsor’s DBA name |
SAME |
Plan sponsor’s mailing address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Plan sponsor’s
address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Plan administrator’s name and address
Administrator’s EIN |
610444707 |
Plan administrator’s name |
BAPTIST HEALTHCARE SYSTEM, INC. |
Plan administrator’s
address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Administrator’s telephone number |
5028965000 |
Number of participants as of the end of the plan year
Active participants |
220 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2011-07-26 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
SEVERANCE PLAN
|
2010
|
610444707
|
2011-07-26
|
BAPTIST HEALTHCARE SYSTEM INC.
|
10562
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2011/07/26/20110726102429P040103586641001.pdf |
Three-digit plan number (PN) |
508 |
Effective date of plan |
1991-03-26 |
Business code |
622000 |
Sponsor’s telephone number |
5028965000 |
Plan
sponsor’s DBA name |
SAME |
Plan sponsor’s mailing address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Plan sponsor’s
address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Plan administrator’s name and address
Administrator’s EIN |
610444707 |
Plan administrator’s name |
BAPTIST HEALTHCARE SYSTEM INC. |
Plan administrator’s
address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Administrator’s telephone number |
5028965000 |
Number of participants as of the end of the plan year
Active participants |
10562 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2011-07-26 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
GROUP DISABILITY PLAN
|
2010
|
610444707
|
2011-07-26
|
BAPTIST HEALTHCARE SYSTEM INC.
|
7913
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2011/07/26/20110726094406P030014751538001.pdf |
Three-digit plan number (PN) |
505 |
Effective date of plan |
1989-01-01 |
Business code |
622000 |
Sponsor’s telephone number |
5028965000 |
Plan
sponsor’s DBA name |
SAME |
Plan sponsor’s mailing address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Plan sponsor’s
address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Plan administrator’s name and address
Administrator’s EIN |
610444707 |
Plan administrator’s name |
BAPTIST HEALTHCARE SYSTEM INC. |
Plan administrator’s
address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Administrator’s telephone number |
5028965000 |
Number of participants as of the end of the plan year
Active participants |
7913 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2011-07-26 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
VISION PLAN
|
2010
|
610444707
|
2011-07-26
|
BAPTIST HEALTHCARE SYSTEM INC.
|
5041
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2011/07/26/20110726145919P040103759921001.pdf |
Three-digit plan number (PN) |
511 |
Effective date of plan |
2010-01-01 |
Business code |
622000 |
Sponsor’s telephone number |
5028965000 |
Plan
sponsor’s DBA name |
SAME |
Plan sponsor’s mailing address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Plan sponsor’s
address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Plan administrator’s name and address
Administrator’s EIN |
610444707 |
Plan administrator’s name |
BAPTIST HEALTHCARE SYSTEM INC. |
Plan administrator’s
address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Administrator’s telephone number |
5028965000 |
Number of participants as of the end of the plan year
Active participants |
5041 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2011-07-26 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
SHORT TERM DISABILITY PLAN
|
2010
|
610444707
|
2011-07-26
|
BAPTIST HEALTHCARE SYSTEM INC.
|
2130
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2011/07/26/20110726142058P040103724289001.pdf |
Three-digit plan number (PN) |
510 |
Effective date of plan |
1993-01-01 |
Business code |
622000 |
Sponsor’s telephone number |
5028965000 |
Plan
sponsor’s DBA name |
SAME |
Plan sponsor’s mailing address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Plan sponsor’s
address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Plan administrator’s name and address
Administrator’s EIN |
610444707 |
Plan administrator’s name |
BAPTIST HEALTHCARE SYSTEM INC. |
Plan administrator’s
address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Administrator’s telephone number |
5028965000 |
Number of participants as of the end of the plan year
Active participants |
2130 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2011-07-26 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
MANAGEMENT DISABILITY PLAN
|
2010
|
610444707
|
2011-07-25
|
BAPTIST HEALTHCARE SYSTEM, INC.
|
215
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2011/07/25/20110725144208P040015200818001.pdf |
Three-digit plan number (PN) |
504 |
Effective date of plan |
1979-09-01 |
Business code |
622000 |
Sponsor’s telephone number |
5028965000 |
Plan
sponsor’s DBA name |
SAME |
Plan sponsor’s mailing address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Plan sponsor’s
address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Plan administrator’s name and address
Administrator’s EIN |
610444707 |
Plan administrator’s name |
BAPTIST HEALTHCARE SYSTEM, INC. |
Plan administrator’s
address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Administrator’s telephone number |
5028965000 |
Number of participants as of the end of the plan year
Active participants |
215 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2011-07-25 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
MANAGEMENT DISABILITY PLAN
|
2010
|
610444707
|
2011-07-25
|
BAPTIST HEALTHCARE SYSTEM, INC.
|
215
|
|
Three-digit plan number (PN) |
504 |
Effective date of plan |
1979-09-01 |
Business code |
622000 |
Sponsor’s telephone number |
5028965000 |
Plan
sponsor’s DBA name |
SAME |
Plan sponsor’s mailing address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Plan sponsor’s
address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Plan administrator’s name and address
Administrator’s EIN |
610444707 |
Plan administrator’s name |
BAPTIST HEALTHCARE SYSTEM, INC. |
Plan administrator’s
address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Administrator’s telephone number |
5028965000 |
Number of participants as of the end of the plan year
Active participants |
215 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Employer/plan sponsor |
Date |
2011-07-25 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
GROUP AD&D
|
2010
|
610444707
|
2011-07-25
|
BAPTIST HEALTHCARE SYSTEM, INC.
|
11066
|
|
Three-digit plan number (PN) |
503 |
Effective date of plan |
1968-04-01 |
Business code |
622000 |
Sponsor’s telephone number |
5028965000 |
Plan
sponsor’s DBA name |
SAME |
Plan sponsor’s mailing address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Plan sponsor’s
address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Plan administrator’s name and address
Administrator’s EIN |
610444707 |
Plan administrator’s name |
BAPTIST HEALTHCARE SYSTEM, INC. |
Plan administrator’s
address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Administrator’s telephone number |
5028965000 |
Number of participants as of the end of the plan year
Active participants |
11066 |
Retired or separated participants receiving
benefits |
0 |
Signature of
Role |
Employer/plan sponsor |
Date |
2011-07-25 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
GROUP AD&D
|
2010
|
610444707
|
2011-07-25
|
BAPTIST HEALTHCARE SYSTEM, INC.
|
11066
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2011/07/25/20110725143317P040103063201001.pdf |
Three-digit plan number (PN) |
503 |
Effective date of plan |
1968-04-01 |
Business code |
622000 |
Sponsor’s telephone number |
5028965000 |
Plan
sponsor’s DBA name |
SAME |
Plan sponsor’s mailing address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Plan sponsor’s
address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Plan administrator’s name and address
Administrator’s EIN |
610444707 |
Plan administrator’s name |
BAPTIST HEALTHCARE SYSTEM, INC. |
Plan administrator’s
address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Administrator’s telephone number |
5028965000 |
Number of participants as of the end of the plan year
Active participants |
11066 |
Retired or separated participants receiving
benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2011-07-25 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
GROUP LIFE INSURANCE
|
2010
|
610444707
|
2011-07-15
|
BAPTIST HEALTHCARE SYSTEM INC.
|
11066
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2011/07/15/20110715131333P030094145537001.pdf |
Three-digit plan number (PN) |
502 |
Effective date of plan |
1968-04-01 |
Business code |
622000 |
Sponsor’s telephone number |
5028965000 |
Plan
sponsor’s DBA name |
SAME |
Plan sponsor’s mailing address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Plan sponsor’s
address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Plan administrator’s name and address
Administrator’s EIN |
610444707 |
Plan administrator’s name |
BAPTIST HEALTHCARE SYSTEM INC. |
Plan administrator’s
address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Administrator’s telephone number |
5028965000 |
Number of participants as of the end of the plan year
Active participants |
10100 |
Retired or separated participants receiving
benefits |
966 |
Signature of
Role |
Plan administrator |
Date |
2011-07-15 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
SHORT TERM DISABILITY PLAN
|
2009
|
610444707
|
2010-07-15
|
BAPTIST HEALTHCARE SYSTEM, INC.
|
2328
|
|
Three-digit plan number (PN) |
510 |
Effective date of plan |
1993-01-01 |
Business code |
622000 |
Sponsor’s telephone number |
5028965000 |
Plan
sponsor’s DBA name |
SAME |
Plan sponsor’s mailing address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Plan sponsor’s
address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Plan administrator’s name and address
Administrator’s EIN |
610444707 |
Plan administrator’s name |
BAPTIST HEALTHCARE SYSTEM, INC. |
Plan administrator’s
address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Administrator’s telephone number |
5028965000 |
Number of participants as of the end of the plan year
Active participants |
2328 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Employer/plan sponsor |
Date |
2010-07-15 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
GROUP LIFE INSURANCE
|
2009
|
610444707
|
2010-07-15
|
BAPTIST HEALTHCARE SYSTEM, INC.
|
10562
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2010/07/15/20100715131651P040091810264001.pdf |
Three-digit plan number (PN) |
502 |
Effective date of plan |
1968-04-01 |
Business code |
622000 |
Sponsor’s telephone number |
5028965000 |
Plan
sponsor’s DBA name |
SAME |
Plan sponsor’s mailing address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Plan sponsor’s
address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Plan administrator’s name and address
Administrator’s EIN |
610444707 |
Plan administrator’s name |
BAPTIST HEALTHCARE SYSTEM, INC. |
Plan administrator’s
address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Administrator’s telephone number |
5028965000 |
Number of participants as of the end of the plan year
Active participants |
9596 |
Retired or separated participants receiving
benefits |
966 |
Signature of
Role |
Plan administrator |
Date |
2010-07-15 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BAPTIST HEALTHCARE SYSTEM, INC. RETIREMENT ACCUMULATION PLAN
|
2009
|
610444707
|
2010-10-14
|
BAPTIST HEALTHCARE SYSTEM, INC.
|
9919
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2010/10/14/20101014165120P070027520497001.pdf |
Three-digit plan number (PN) |
002 |
Effective date of plan |
1993-03-01 |
Business code |
622000 |
Sponsor’s telephone number |
5028965050 |
Plan sponsor’s mailing address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Plan sponsor’s
address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Plan administrator’s name and address
Administrator’s EIN |
610444707 |
Plan administrator’s name |
BAPTIST HEALTHCARE SYSTEM, INC. |
Plan administrator’s
address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Administrator’s telephone number |
5028965050 |
Number of participants as of the end of the plan year
Active participants |
9522 |
Retired or separated participants receiving
benefits |
49 |
Other
retired or separated participants entitled to future benefits |
1513 |
Deceased participants
whose
beneficiaries are receiving or are entitled to receive benefits |
3 |
Number of
participants
with
account balances as of the end of the plan year |
8564 |
Number of participants that
terminated
employment during the plan year with accrued benefits that were less than 100%
vested |
215 |
Signature of
Role |
Plan administrator |
Date |
2010-10-14 |
Name of individual signing |
MICHAEL DAUGHERTY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BAPTIST HEALTHCARE SYSTEM, INC. RETIREMENT ACCUMULATION PLAN
|
2009
|
610444707
|
2010-10-14
|
BAPTIST HEALTHCARE SYSTEM, INC.
|
9919
|
|
Three-digit plan number (PN) |
002 |
Effective date of plan |
1993-03-01 |
Business code |
622000 |
Sponsor’s telephone number |
5028965050 |
Plan sponsor’s mailing address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Plan sponsor’s
address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Plan administrator’s name and address
Administrator’s EIN |
610444707 |
Plan administrator’s name |
BAPTIST HEALTHCARE SYSTEM, INC. |
Plan administrator’s
address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Administrator’s telephone number |
5028965050 |
Number of participants as of the end of the plan year
Active participants |
9522 |
Retired or separated participants receiving
benefits |
49 |
Other
retired or separated participants entitled to future benefits |
1513 |
Deceased participants
whose
beneficiaries are receiving or are entitled to receive benefits |
3 |
Number of
participants
with
account balances as of the end of the plan year |
8564 |
Number of participants that
terminated
employment during the plan year with accrued benefits that were less than 100%
vested |
215 |
Signature of
Role |
Employer/plan sponsor |
Date |
2010-10-14 |
Name of individual signing |
MICHAEL DAUGHERTY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BAPTIST REGIONAL MED CTR HEALTH PLAN
|
2009
|
311593064
|
2010-07-15
|
BAPTIST HEALTHCARE SYSTEM, INC.
|
1067
|
|
Three-digit plan number (PN) |
501 |
Effective date of plan |
1997-01-01 |
Business code |
622000 |
Sponsor’s telephone number |
5028965000 |
Plan
sponsor’s DBA name |
BAPTIST REGIONAL MEDICAL CENTER |
Plan sponsor’s mailing address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Plan sponsor’s
address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Plan administrator’s name and address
Administrator’s EIN |
311593064 |
Plan administrator’s name |
BAPTIST HEALTHCARE SYSTEM, INC. |
Plan administrator’s
address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Administrator’s telephone number |
5028965000 |
Number of participants as of the end of the plan year
Active participants |
1057 |
Retired or separated participants receiving
benefits |
10 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Employer/plan sponsor |
Date |
2010-07-15 |
Name of individual signing |
MICHAEL DAUGHERTY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
DENTAL PLAN
|
2009
|
610444707
|
2010-07-15
|
BAPTIST HEALTHCARE SYSTEM, INC.
|
6229
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2010/07/15/20100715135310P040091823064001.pdf |
Three-digit plan number (PN) |
506 |
Effective date of plan |
1989-01-01 |
Business code |
622000 |
Sponsor’s telephone number |
5028965000 |
Plan
sponsor’s DBA name |
SAME |
Plan sponsor’s mailing address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Plan sponsor’s
address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Plan administrator’s name and address
Administrator’s EIN |
610444707 |
Plan administrator’s name |
BAPTIST HEALTHCARE SYSTEM, INC. |
Plan administrator’s
address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Administrator’s telephone number |
5028965000 |
Number of participants as of the end of the plan year
Active participants |
6229 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2010-07-15 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BAPTIST HEALTHCARE SYSTEM, INC. THRIFT PLAN
|
2009
|
610444707
|
2010-10-14
|
BAPTIST HEALTHCARE SYSTEM, INC.
|
9919
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2010/10/14/20101014164757P070027513665001.pdf |
Three-digit plan number (PN) |
003 |
Effective date of plan |
1993-06-01 |
Business code |
622000 |
Sponsor’s telephone number |
5028965050 |
Plan sponsor’s mailing address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Plan sponsor’s
address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Plan administrator’s name and address
Administrator’s EIN |
610444707 |
Plan administrator’s name |
BAPTIST HEALTHCARE SYSTEM, INC. |
Plan administrator’s
address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Administrator’s telephone number |
5028965050 |
Number of participants as of the end of the plan year
Active participants |
10569 |
Retired or separated participants receiving
benefits |
38 |
Other
retired or separated participants entitled to future benefits |
834 |
Deceased participants
whose
beneficiaries are receiving or are entitled to receive benefits |
2 |
Number of
participants
with
account balances as of the end of the plan year |
7984 |
Number of participants that
terminated
employment during the plan year with accrued benefits that were less than 100%
vested |
176 |
Signature of
Role |
Employer/plan sponsor |
Date |
2010-10-14 |
Name of individual signing |
MICHAEL DAUGHERTY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BAPTIST HEALTHCARE SYSTEM, INC. THRIFT PLAN
|
2009
|
610444707
|
2010-10-14
|
BAPTIST HEALTHCARE SYSTEM, INC.
|
9919
|
|
Three-digit plan number (PN) |
003 |
Effective date of plan |
1993-06-01 |
Business code |
622000 |
Sponsor’s telephone number |
5028965050 |
Plan sponsor’s mailing address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Plan sponsor’s
address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Plan administrator’s name and address
Administrator’s EIN |
610444707 |
Plan administrator’s name |
BAPTIST HEALTHCARE SYSTEM, INC. |
Plan administrator’s
address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Administrator’s telephone number |
5028965050 |
Number of participants as of the end of the plan year
Active participants |
10569 |
Retired or separated participants receiving
benefits |
38 |
Other
retired or separated participants entitled to future benefits |
834 |
Deceased participants
whose
beneficiaries are receiving or are entitled to receive benefits |
2 |
Number of
participants
with
account balances as of the end of the plan year |
7984 |
Number of participants that
terminated
employment during the plan year with accrued benefits that were less than 100%
vested |
176 |
Signature of
Role |
Plan administrator |
Date |
2010-10-14 |
Name of individual signing |
MICHAEL DAUGHERTY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BAPTIST HEALTHCARE SYSTEM, INC. THRIFT PLAN
|
2009
|
610444707
|
2010-10-14
|
BAPTIST HEALTHCARE SYSTEM, INC.
|
9919
|
|
Three-digit plan number (PN) |
003 |
Effective date of plan |
1993-06-01 |
Business code |
622000 |
Sponsor’s telephone number |
5028965050 |
Plan sponsor’s mailing address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Plan sponsor’s
address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Plan administrator’s name and address
Administrator’s EIN |
610444707 |
Plan administrator’s name |
BAPTIST HEALTHCARE SYSTEM, INC. |
Plan administrator’s
address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Administrator’s telephone number |
5028965050 |
Number of participants as of the end of the plan year
Active participants |
10569 |
Retired or separated participants receiving
benefits |
38 |
Other
retired or separated participants entitled to future benefits |
834 |
Deceased participants
whose
beneficiaries are receiving or are entitled to receive benefits |
2 |
Number of
participants
with
account balances as of the end of the plan year |
7984 |
Number of participants that
terminated
employment during the plan year with accrued benefits that were less than 100%
vested |
176 |
Signature of
Role |
Employer/plan sponsor |
Date |
2010-10-14 |
Name of individual signing |
MICHAEL DAUGHERTY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
SHORT TERM DISABILITY PLAN
|
2009
|
610444707
|
2010-07-15
|
BAPTIST HEALTHCARE SYSTEM, INC.
|
2328
|
|
Three-digit plan number (PN) |
510 |
Effective date of plan |
1993-01-01 |
Business code |
622000 |
Sponsor’s telephone number |
5028965000 |
Plan
sponsor’s DBA name |
SAME |
Plan sponsor’s mailing address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Plan sponsor’s
address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Plan administrator’s name and address
Administrator’s EIN |
610444707 |
Plan administrator’s name |
BAPTIST HEALTHCARE SYSTEM, INC. |
Plan administrator’s
address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Administrator’s telephone number |
5028965000 |
Number of participants as of the end of the plan year
Active participants |
2328 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2010-07-15 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
HEALTH PLAN
|
2009
|
610444707
|
2010-07-14
|
BAPTIST HEALTHCARE SYSTEM, INC.
|
3099
|
|
Three-digit plan number (PN) |
501 |
Effective date of plan |
1983-03-01 |
Business code |
622000 |
Sponsor’s telephone number |
5028965000 |
Plan
sponsor’s DBA name |
SAME |
Plan sponsor’s mailing address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Plan sponsor’s
address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Plan administrator’s name and address
Administrator’s EIN |
610444707 |
Plan administrator’s name |
BAPTIST HEALTHCARE SYSTEM, INC. |
Plan administrator’s
address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Administrator’s telephone number |
5028965000 |
Number of participants as of the end of the plan year
Active participants |
3019 |
Retired or separated participants receiving
benefits |
80 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Employer/plan sponsor |
Date |
2010-07-14 |
Name of individual signing |
MICHAEL DAUGHERTY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
DENTAL PLAN
|
2009
|
610444707
|
2010-07-14
|
BAPTIST HEALTHCARE SYSTEM, INC.
|
6229
|
|
Three-digit plan number (PN) |
506 |
Effective date of plan |
1989-01-01 |
Business code |
622000 |
Sponsor’s telephone number |
5028965000 |
Plan
sponsor’s DBA name |
SAME |
Plan sponsor’s mailing address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Plan sponsor’s
address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Plan administrator’s name and address
Administrator’s EIN |
610444707 |
Plan administrator’s name |
BAPTIST HEALTHCARE SYSTEM, INC. |
Plan administrator’s
address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Administrator’s telephone number |
5028965000 |
Number of participants as of the end of the plan year
Active participants |
6229 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Employer/plan sponsor |
Date |
2010-07-14 |
Name of individual signing |
MICHAEL DAUGHERTY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BAPTIST REGIONAL MED CTR HEALTH PLAN
|
2009
|
311593064
|
2010-07-14
|
BAPTIST HEALTHCARE SYSTEM, INC.
|
1067
|
|
Three-digit plan number (PN) |
501 |
Effective date of plan |
1997-01-01 |
Business code |
622000 |
Sponsor’s telephone number |
5028965000 |
Plan
sponsor’s DBA name |
BAPTIST REGIONAL MEDICAL CENTER |
Plan sponsor’s mailing address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Plan sponsor’s
address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Plan administrator’s name and address
Administrator’s EIN |
311593064 |
Plan administrator’s name |
BAPTIST HEALTHCARE SYSTEM, INC. |
Plan administrator’s
address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Administrator’s telephone number |
5028965000 |
Number of participants as of the end of the plan year
Active participants |
1057 |
Retired or separated participants receiving
benefits |
10 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Employer/plan sponsor |
Date |
2010-07-14 |
Name of individual signing |
MICHAEL DAUGHERTY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
EMPLOYEE ASSISTANCE PLAN
|
2009
|
610444707
|
2010-07-14
|
BAPTIST HEALTHCARE SYSTEM, INC.
|
4750
|
|
Three-digit plan number (PN) |
507 |
Effective date of plan |
1988-01-01 |
Business code |
622000 |
Sponsor’s telephone number |
5028965000 |
Plan
sponsor’s DBA name |
SAME |
Plan sponsor’s mailing address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Plan sponsor’s
address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Plan administrator’s name and address
Administrator’s EIN |
610444707 |
Plan administrator’s name |
BAPTIST HEALTHCARE SYSTEM, INC. |
Plan administrator’s
address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Administrator’s telephone number |
5028965000 |
Number of participants as of the end of the plan year
Active participants |
4750 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Employer/plan sponsor |
Date |
2010-07-14 |
Name of individual signing |
MICHAEL DAUGHERTY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
SEVERANCE PLAN
|
2009
|
610444707
|
2010-07-14
|
BAPTIST HEALTHCARE SYSTEM, INC.
|
10562
|
|
Three-digit plan number (PN) |
508 |
Effective date of plan |
1991-03-26 |
Business code |
622000 |
Sponsor’s telephone number |
5028965000 |
Plan
sponsor’s DBA name |
SAME |
Plan sponsor’s mailing address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Plan sponsor’s
address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Plan administrator’s name and address
Administrator’s EIN |
610444707 |
Plan administrator’s name |
BAPTIST HEALTHCARE SYSTEM, INC. |
Plan administrator’s
address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Administrator’s telephone number |
5028965000 |
Number of participants as of the end of the plan year
Active participants |
10562 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Employer/plan sponsor |
Date |
2010-07-14 |
Name of individual signing |
MICHAEL DAUGHERTY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BUSINESS TRAVEL ACCIDENT
|
2009
|
610444707
|
2010-07-14
|
BAPTIST HEALTHCARE SYSTEM, INC.
|
211
|
|
Three-digit plan number (PN) |
509 |
Effective date of plan |
1968-04-01 |
Business code |
622000 |
Sponsor’s telephone number |
5028965000 |
Plan
sponsor’s DBA name |
SAME |
Plan sponsor’s mailing address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Plan sponsor’s
address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Plan administrator’s name and address
Administrator’s EIN |
610444707 |
Plan administrator’s name |
BAPTIST HEALTHCARE SYSTEM, INC. |
Plan administrator’s
address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Administrator’s telephone number |
5028965000 |
Number of participants as of the end of the plan year
Active participants |
211 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Employer/plan sponsor |
Date |
2010-07-14 |
Name of individual signing |
MICHAEL DAUGHERTY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
GROUP LIFE INSURANCE
|
2009
|
610444707
|
2010-07-14
|
BAPTIST HEALTHCARE SYSTEM, INC.
|
10562
|
|
Three-digit plan number (PN) |
502 |
Effective date of plan |
1968-04-01 |
Business code |
622000 |
Sponsor’s telephone number |
5028965000 |
Plan
sponsor’s DBA name |
SAME |
Plan sponsor’s mailing address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Plan sponsor’s
address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Plan administrator’s name and address
Administrator’s EIN |
610444707 |
Plan administrator’s name |
BAPTIST HEALTHCARE SYSTEM, INC. |
Plan administrator’s
address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Administrator’s telephone number |
5028965000 |
Number of participants as of the end of the plan year
Active participants |
9596 |
Retired or separated participants receiving
benefits |
966 |
Signature of
Role |
Employer/plan sponsor |
Date |
2010-07-14 |
Name of individual signing |
MICHAEL DAUGHERTY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
GROUP AD&D
|
2009
|
610444707
|
2010-07-14
|
BAPTIST HEALTHCARE SYSTEM, INC.
|
9596
|
|
Three-digit plan number (PN) |
503 |
Effective date of plan |
1968-04-01 |
Business code |
622000 |
Sponsor’s telephone number |
5028965000 |
Plan
sponsor’s DBA name |
SAME |
Plan sponsor’s mailing address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Plan sponsor’s
address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Plan administrator’s name and address
Administrator’s EIN |
610444707 |
Plan administrator’s name |
BAPTIST HEALTHCARE SYSTEM, INC. |
Plan administrator’s
address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Administrator’s telephone number |
5028965000 |
Number of participants as of the end of the plan year
Active participants |
9596 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Employer/plan sponsor |
Date |
2010-07-14 |
Name of individual signing |
MICHAEL DAUGHERTY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
MANAGEMENT DISABILITY PLAN
|
2009
|
610444707
|
2010-07-14
|
BAPTIST HEALTHCARE SYSTEM, INC.
|
215
|
|
Three-digit plan number (PN) |
504 |
Effective date of plan |
1979-09-01 |
Business code |
622000 |
Sponsor’s telephone number |
5028965000 |
Plan
sponsor’s DBA name |
SAME |
Plan sponsor’s mailing address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Plan sponsor’s
address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Plan administrator’s name and address
Administrator’s EIN |
610444707 |
Plan administrator’s name |
BAPTIST HEALTHCARE SYSTEM, INC. |
Plan administrator’s
address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Administrator’s telephone number |
5028965000 |
Number of participants as of the end of the plan year
Active participants |
215 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Employer/plan sponsor |
Date |
2010-07-14 |
Name of individual signing |
MICHAEL DAUGHERTY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
GROUP DISABILITY PLAN
|
2009
|
610444707
|
2010-07-14
|
BAPTIST HEALTHCARE SYSTEM, INC.
|
7488
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2010/07/14/20100714131709P030373807969001.pdf |
Three-digit plan number (PN) |
505 |
Effective date of plan |
1989-01-01 |
Business code |
622000 |
Sponsor’s telephone number |
5028965000 |
Plan
sponsor’s DBA name |
SAME |
Plan sponsor’s mailing address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Plan sponsor’s
address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Plan administrator’s name and address
Administrator’s EIN |
610444707 |
Plan administrator’s name |
BAPTIST HEALTHCARE SYSTEM, INC. |
Plan administrator’s
address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Administrator’s telephone number |
5028965000 |
Number of participants as of the end of the plan year
Active participants |
7488 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2010-07-14 |
Name of individual signing |
MICHAEL DAUGHERTY |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2010-07-14 |
Name of individual signing |
MICHAEL DAUGHERTY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
GROUP AD&D
|
2009
|
610444707
|
2010-07-15
|
BAPTIST HEALTHCARE SYSTEM, INC.
|
9596
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2010/07/15/20100715133020P040091815112001.pdf |
Three-digit plan number (PN) |
503 |
Effective date of plan |
1968-04-01 |
Business code |
622000 |
Sponsor’s telephone number |
5028965000 |
Plan
sponsor’s DBA name |
SAME |
Plan sponsor’s mailing address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Plan sponsor’s
address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Plan administrator’s name and address
Administrator’s EIN |
610444707 |
Plan administrator’s name |
BAPTIST HEALTHCARE SYSTEM, INC. |
Plan administrator’s
address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Administrator’s telephone number |
5028965000 |
Number of participants as of the end of the plan year
Active participants |
9596 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2010-07-15 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
MANAGEMENT DISABILITY PLAN
|
2009
|
610444707
|
2010-07-15
|
BAPTIST HEALTHCARE SYSTEM, INC.
|
215
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2010/07/15/20100715134146P040376753249001.pdf |
Three-digit plan number (PN) |
504 |
Effective date of plan |
1979-09-01 |
Business code |
622000 |
Sponsor’s telephone number |
5028965000 |
Plan
sponsor’s DBA name |
SAME |
Plan sponsor’s mailing address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Plan sponsor’s
address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Plan administrator’s name and address
Administrator’s EIN |
610444707 |
Plan administrator’s name |
BAPTIST HEALTHCARE SYSTEM, INC. |
Plan administrator’s
address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Administrator’s telephone number |
5028965000 |
Number of participants as of the end of the plan year
Active participants |
215 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2010-07-15 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
EMPLOYEE ASSISTANCE PLAN
|
2009
|
610444707
|
2010-07-15
|
BAPTIST HEALTHCARE SYSTEM, INC.
|
4750
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2010/07/15/20100715125338P030127044818001.pdf |
Three-digit plan number (PN) |
507 |
Effective date of plan |
1988-01-01 |
Business code |
622000 |
Sponsor’s telephone number |
5028965000 |
Plan
sponsor’s DBA name |
SAME |
Plan sponsor’s mailing address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Plan sponsor’s
address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Plan administrator’s name and address
Administrator’s EIN |
610444707 |
Plan administrator’s name |
BAPTIST HEALTHCARE SYSTEM, INC. |
Plan administrator’s
address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Administrator’s telephone number |
5028965000 |
Number of participants as of the end of the plan year
Active participants |
4750 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2010-07-15 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
SEVERANCE PLAN
|
2009
|
610444707
|
2010-07-15
|
BAPTIST HEALTHCARE SYSTEM, INC.
|
10562
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2010/07/15/20100715125300P070012241560001.pdf |
Three-digit plan number (PN) |
508 |
Effective date of plan |
1991-03-26 |
Business code |
622000 |
Sponsor’s telephone number |
5028965000 |
Plan
sponsor’s DBA name |
SAME |
Plan sponsor’s mailing address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Plan sponsor’s
address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Plan administrator’s name and address
Administrator’s EIN |
610444707 |
Plan administrator’s name |
BAPTIST HEALTHCARE SYSTEM, INC. |
Plan administrator’s
address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Administrator’s telephone number |
5028965000 |
Number of participants as of the end of the plan year
Active participants |
10562 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2010-07-15 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BAPTIST REGIONAL MED CTR HEALTH PLAN
|
2009
|
311593064
|
2010-07-15
|
BAPTIST HEALTHCARE SYSTEM, INC.
|
1067
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2010/07/15/20100715123333P040013685573001.pdf |
Three-digit plan number (PN) |
501 |
Effective date of plan |
1997-01-01 |
Business code |
622000 |
Sponsor’s telephone number |
5028965000 |
Plan
sponsor’s DBA name |
BAPTIST REGIONAL MEDICAL CENTER |
Plan sponsor’s mailing address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Plan sponsor’s
address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Plan administrator’s name and address
Administrator’s EIN |
311593064 |
Plan administrator’s name |
BAPTIST HEALTHCARE SYSTEM, INC. |
Plan administrator’s
address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Administrator’s telephone number |
5028965000 |
Number of participants as of the end of the plan year
Active participants |
1057 |
Retired or separated participants receiving
benefits |
10 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2010-07-15 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
SHORT TERM DISABILITY PLAN
|
2009
|
610444707
|
2010-07-15
|
BAPTIST HEALTHCARE SYSTEM, INC.
|
2328
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2010/07/15/20100715124503P070016680194001.pdf |
Three-digit plan number (PN) |
510 |
Effective date of plan |
1993-01-01 |
Business code |
622000 |
Sponsor’s telephone number |
5028965000 |
Plan
sponsor’s DBA name |
SAME |
Plan sponsor’s mailing address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Plan sponsor’s
address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Plan administrator’s name and address
Administrator’s EIN |
610444707 |
Plan administrator’s name |
BAPTIST HEALTHCARE SYSTEM, INC. |
Plan administrator’s
address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Administrator’s telephone number |
5028965000 |
Number of participants as of the end of the plan year
Active participants |
2328 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2010-07-15 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BUSINESS TRAVEL ACCIDENT
|
2009
|
610444707
|
2010-07-15
|
BAPTIST HEALTHCARE SYSTEM, INC.
|
211
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2010/07/15/20100715125851P030127048786001.pdf |
Three-digit plan number (PN) |
509 |
Effective date of plan |
1968-04-01 |
Business code |
622000 |
Sponsor’s telephone number |
5028965000 |
Plan
sponsor’s DBA name |
SAME |
Plan sponsor’s mailing address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Plan sponsor’s
address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Plan administrator’s name and address
Administrator’s EIN |
610444707 |
Plan administrator’s name |
BAPTIST HEALTHCARE SYSTEM, INC. |
Plan administrator’s
address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Administrator’s telephone number |
5028965000 |
Number of participants as of the end of the plan year
Active participants |
211 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2010-07-15 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BAPTIST HEALTHCARE SYSTEM INC. THRIFT PLAN
|
2009
|
610444707
|
2010-07-16
|
BAPTIST HEALTHCARE SYSTEM, INC.
|
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2010/07/16/20100716100210P040121954786001.pdf |
Three-digit plan number (PN) |
003 |
Effective date of plan |
1993-06-01 |
Business code |
622000 |
Sponsor’s telephone number |
5028965000 |
Plan
sponsor’s DBA name |
SAME |
Plan sponsor’s mailing address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Plan sponsor’s
address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Plan administrator’s name and address
Administrator’s EIN |
610444707 |
Plan administrator’s name |
BAPTIST HEALTHCARE SYSTEM, INC. |
Plan administrator’s
address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Administrator’s telephone number |
5028965000 |
Signature of
Role |
Plan administrator |
Date |
2010-07-16 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
HEALTH PLAN
|
2009
|
610444707
|
2010-07-15
|
BAPTIST HEALTHCARE SYSTEM, INC.
|
3099
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2010/07/15/20100715131120P030040011347001.pdf |
Three-digit plan number (PN) |
501 |
Effective date of plan |
1983-03-01 |
Business code |
622000 |
Sponsor’s telephone number |
5028965000 |
Plan
sponsor’s DBA name |
SAME |
Plan sponsor’s mailing address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Plan sponsor’s
address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Plan administrator’s name and address
Administrator’s EIN |
610444707 |
Plan administrator’s name |
BAPTIST HEALTHCARE SYSTEM, INC. |
Plan administrator’s
address |
4007 KRESGE WAY, LOUISVILLE, KY, 40207 |
Administrator’s telephone number |
5028965000 |
Number of participants as of the end of the plan year
Active participants |
3019 |
Retired or separated participants receiving
benefits |
80 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2010-07-15 |
Name of individual signing |
PATRICIA BLAIR |
Valid signature |
Filed with authorized/valid electronic signature |
|
|