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LIFE AND ACCIDENTAL DEATH INSURANCE 401k Plan overview

Plan NameLIFE AND ACCIDENTAL DEATH INSURANCE
Plan identification number 504

LIFE AND ACCIDENTAL DEATH INSURANCE Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Life insurance
  • Death benefits (include travel accident but not life insurance)
  • Unfunded, fully insured, or combination unfunded/insured welfare plan that will not file a Form 5500 for next plan year pursuant to 29 CFR 2520.104-20.

401k Sponsoring company profile

SAINT JOSEPH'S REHABILITATION AND RESIDENCE has sponsored the creation of one or more 401k plans.

Company Name:SAINT JOSEPH'S REHABILITATION AND RESIDENCE
Employer identification number (EIN):010339489
NAIC Classification:623000
NAIC Description: Nursing and Residential Care Facilities

Form 5500 Filing Information

Submission information for form 5500 for 401k plan LIFE AND ACCIDENTAL DEATH INSURANCE

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5042016-09-01
5042010-08-02DAVID HAMLIN
5042009-08-02DAVID HAMLIN

Plan Statistics for LIFE AND ACCIDENTAL DEATH INSURANCE

401k plan membership statisitcs for LIFE AND ACCIDENTAL DEATH INSURANCE

Measure Date Value
2016: LIFE AND ACCIDENTAL DEATH INSURANCE 2016 401k membership
Total participants, beginning-of-year2016-09-01105
Total number of active participants reported on line 7a of the Form 55002016-09-0191
Number of retired or separated participants receiving benefits2016-09-010
Number of other retired or separated participants entitled to future benefits2016-09-010
Total of all active and inactive participants2016-09-0191
2010: LIFE AND ACCIDENTAL DEATH INSURANCE 2010 401k membership
Total participants, beginning-of-year2010-08-02124
Total number of active participants reported on line 7a of the Form 55002010-08-02125
Total of all active and inactive participants2010-08-02125
Total participants2010-08-02125
2009: LIFE AND ACCIDENTAL DEATH INSURANCE 2009 401k membership
Total participants, beginning-of-year2009-08-02118
Total number of active participants reported on line 7a of the Form 55002009-08-02124
Number of retired or separated participants receiving benefits2009-08-020
Number of other retired or separated participants entitled to future benefits2009-08-020
Total of all active and inactive participants2009-08-02124
Total participants2009-08-02124

Form 5500 Responses for LIFE AND ACCIDENTAL DEATH INSURANCE

2016: LIFE AND ACCIDENTAL DEATH INSURANCE 2016 form 5500 responses
2016-09-01Type of plan entitySingle employer plan
2016-09-01Submission has been amendedNo
2016-09-01This submission is the final filingNo
2016-09-01This return/report is a short plan year return/report (less than 12 months)No
2016-09-01Plan is a collectively bargained planNo
2016-09-01Plan funding arrangement – InsuranceYes
2016-09-01Plan benefit arrangement – InsuranceYes
2010: LIFE AND ACCIDENTAL DEATH INSURANCE 2010 form 5500 responses
2010-08-02Type of plan entitySingle employer plan
2010-08-02Submission has been amendedNo
2010-08-02This submission is the final filingNo
2010-08-02This return/report is a short plan year return/report (less than 12 months)No
2010-08-02Plan is a collectively bargained planNo
2010-08-02Plan funding arrangement – InsuranceYes
2010-08-02Plan benefit arrangement – InsuranceYes
2009: LIFE AND ACCIDENTAL DEATH INSURANCE 2009 form 5500 responses
2009-08-02Type of plan entitySingle employer plan
2009-08-02Submission has been amendedNo
2009-08-02This submission is the final filingNo
2009-08-02This return/report is a short plan year return/report (less than 12 months)No
2009-08-02Plan is a collectively bargained planNo
2009-08-02Plan funding arrangement – InsuranceYes
2009-08-02Plan benefit arrangement – InsuranceYes

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