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FORM 5500 DATA

Neighborhood Health Plan of Rhode Island 401k Plan

Overview

Plan Information

  • Plan Year01/01/2016 — 12/31/2016
  • Date of Plan01/01/1996
  • Net Assets as of 12/31/2016 $21,400,651
  • Plan Number1
  • Plan Type Single Employer
  • Is the plan collectively bargained? No
  • Did the plan file for an extension of time or the DFVC Program?Yes
  • Plan Funding Arrangement Trust
  • Plan Benefit Arrangement Trust

Participant Information as of 12/31/2016

  • Active (Eligible) Participants491
  • Retired or separated participants receiving benefits0
  • Other retired or separated participants entitled to future benefits74
  • Subtotal565
  • Deceased participants whose beneficiaries are receiving or are entitled to receive benefits0
  • Total565
  • Total number of participants as of 01/01/2016471
  • Number of participants with account balances539
  • Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested0

Expenses

  • Total Benefit Payments$0
  • Corrective Distributions$0
  • Administrative Service Providers$0
  • Other Expenses$0
  • Total Expenses$0
  • Total Transfers$0

Sponsor Information

  • Address910 Douglas Pike
  • CitySmithfield
  • StateRI
  • Zip02917
  • Telephone(401) 459-6000
  • EIN05-0477052
  • Industry Code524290
  • Named AdministratorLisa Whiting
  • Named Plan SponsorLisa Whiting

Audit Information

  • Audit StatusAudited
  • AuditorBdo USA LLP
  • Auditor EIN13-5381590
  • Audit Opinion Disclaimer
  • Audit TypeLimited Scope Audit

Benefits Provided Under the Plan

Code Benefit Description
2E Profit-sharing A defined contribution plan that allows employer discretionary contributions. These plans often contain a 401(k) feature.
2F ERISA section 404(c) Plan This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
2G Total participant-directed account plan Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
2J Code section 401(k) feature A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
2K Code section 401(m) arrangement Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contributions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
2S Automatic Enrollment Plan provides for automatic enrollment in plan that has employee contributions deducted from payroll.
2T Participant-directed Account Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
3D Master plan A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.

Questions and Answers

Question Answer Amount
During the plan year did the employer fail to transmit to the plan any participant contributions within the time period described in 29 CFT 2510.3-102? No
Were any loans by the plan or fixed income obligations due the plan in default as of the close of plan year or classified during the year as uncollectible? Disregard participant loans secured by participant's account balance. No
Were any leases to which the plan was a party in default or classified during the year as uncollectible? No
Were there any nonexempt transactions with any party-in-interest? No
Was this plan covered by a fidelity bond? Yes $1,000,000
Did the plan have a loss, whether or not reimbursed by the plan's fidelity bond, that was caused by fraud or dishonesty? No
Did the plan hold any assets whose current value was neither readily determinable on an established market nor set by an independent third party appraiser? No
Did the plan receive any noncash contributions whose value was neither readily determinable on an established market nor set by an independent third party appraiser? No
Did the plan have assets held for investment? Yes
Were any plan transactions or series of transactions in excess of 5% of the current value of plan assets? No
Were all the plan assets either distributed to participants or beneficiaries, transferred to another plan, or brought under the control of the PBGC? No
Has the plan failed to provide any benefit when due under the plan? No
If this is an individual account plan, was there a blackout period? Yes
If there was a blackout period, have you either provided the required notice or one of the exceptions to providing the notice applied under 29 CFR 2520.101-3? Yes

Financials

Income and Expense Statement

Income $5,614,894
Contributions $3,665,303
Cash Contributions $3,665,303
Cash from Employers $990,190
Cash from Participants $2,137,480
Others (including rollovers) $537,633
Noncash Contributions $0
Total Earnings on Investments $1,949,394
Total Interest $20,314
Interest-Bearing Cash $0
U.S. Government Securities $0
Corporate Debt Instruments $0
Loans (other than to participants) $0
Participant Loans $20,314
Interest from Other Investments $0
Total Dividends $336,682
Preferred Stock $0
Common Stock $0
Rents $0
Net gain (loss) on sale of assets $0
Aggregate Proceeds $0
Aggregate Carrying Amount $0
Total Unrealized Appreciation (depreciation) of assets $0
Real Estate $0
Other $0
Net investment gain (loss) from common/collective trusts $12,138
Net investment gain (loss) from pooled separate accounts $0
Net investment gain (loss) from master trust investment accounts $0
Net investment gain (loss) from 103-12 investment entities $0
Net investment gain (loss) from registered investment companies $1,580,260
Other Income $197
Expenses $1,569,075
Total Benefit Payments $1,479,502
Directly to participants or beneficiaries, including direct rollovers $1,479,502
To insurance carriers for the provision of benefits $0
Other Benefit Payment Fees $0
Corrective Distributions $0
Certain deemed distributions of participant loans $1,976
Interest expense $0
Total Administrative Expenses $87,597
Professional Fees $0
Contract Administrator Fees $0
Investment Advisory and management fees $0
Other Administrative Fees $87,597
Net Income $4,045,819
Transfers of Assets to this Plan $0
Transfers of Assets from this Plan $0

Asset and Liability Statement

12/31/2016 12/31/2015 Change YOY
Total Assets $21,400,651 $17,559,042 21.88%
Total noninterest-bearing cash $0 $0 0.0%
Receivables $115,926 $109,081 6.28%
Employer Contributions $38,065 $0 0.0%
Participant Contributions $77,861 $0 0.0%
Other Contributions $0 $109,081 0.0%
General Investments $0 $204,261 0.0%
Interest-bearing cash $0 $204,261 0.0%
U.S. Government Securities $0 $0 0.0%
Corporate Debt Instruments $0 $0 0.0%
Preferred $0 $0 0.0%
All Other $0 $0 0.0%
Corporate Stocks $0 $0 0.0%
Preferred $0 $0 0.0%
Common $0 $0 0.0%
Partnership/joint venture interests $0 $0 0.0%
Real estate (other than employer real property) $0 $0 0.0%
Loans (other than to participants) $0 $0 0.0%
Participants Loans $525,208 $411,125 27.75%
Value of interest in common/collective trusts $1,124,535 $202,323 455.81%
Value of interest in pooled separate accounts $0 $0 0.0%
Value of interest in master trust investment accounts $0 $0 0.0%
Value of interest in 103-12 investment entities $0 $0 0.0%
Value of interest in registered investment companies $19,634,982 $16,632,252 18.05%
Value of funds held in insurance co. general account $0 $0 0.0%
Other Investments $0 $0 0.0%
Employer-related Investments $0 $0 0.0%
Employer Securities $0 $0 0.0%
Employer Real Property $0 $0 0.0%
Buildings and other property used in plan operation $0 $0 0.0%
Total Liabilities $0 $204,210 -100.00%
Benefit Claims Payable (1) $0 $0 0.0%
Operating Payables (1) $0 $204,210 0.0%
Acquisition Indebtedness (1) $0 $0 0.0%
Other liabilities (1) $0 $0 0.0%
Net Assets $21,400,651 $17,354,832 23.31%

Service Providers

Persons Receiving Only Eligible Indirect Compensation

  • Amg Funds
  • American Century Investments
  • Columbia
  • Delaware Investments
  • Driehaus
  • Eaton Vance
  • Fidelity Investments
  • Homestead
  • Metropolitan West Funds
  • Nuveen
  • Oppenheimer Funds
  • Prudential Investments
  • T. Rowe Price
  • Vanguard

Other Service Providers Receiving Direct or Indirect Compensation

Name Nature of Service Relationship to Plan Sponsor Direct Compensation Paid by Plan Indirect Compensation Paid by Plan Total Compensation
Icapital LLC Investment advisory (plan), Direct payment from the plan NONE $47,837 $0 $47,837
Wells Fargo Bank, N.A. Recordkeeping and information management (computing, tabulating, data processing, etc.), Participant loan processing, Direct payment from the plan, Float revenue, Recordkeeping fees Service Provider $21,830 $0 $21,830
Total $69,667 $0 $69,667

Indirect Compensation

There are no service providers with indirect compensation listed for this plan.

Service Providers Who Fail or Refuse to Provide Information

There are no service providers who failed or refused to provide information.

Termination Information on Accountants and Enrolled Actuaries

Name Position Explanation
Ernst & Young LLP Accounting Firm Bso USA, LLP Was Hired To Perform The 2016 Audit and Ernst and Young LLP Was Terminated.

Investments

Investments

Name of Investment Investment Manager Type of Investment Dollar Value
Wells Fargo Stable Return Fund N Wells Fargo Bank, N.A. DFE: Common/Collective Trust $1,124,535
Total $1,124,535

Insurance Information

Insurance Information

There are no insurance carriers listed for this plan.