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| Plan Name | KINGSBROOK JEWISH MEDICAL CENTER DENTAL INSURANCE PLAN |
| Plan identification number | 505 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | KINGSBROOK JEWISH MEDICAL CENTER |
| Employer identification number (EIN): | 121631759 |
| NAIC Classification: | 622000 |
| NAIC Description: | Hospitals |
Additional information about KINGSBROOK JEWISH MEDICAL CENTER
| Jurisdiction of Incorporation: | New York Department of State |
| Incorporation Date: | 1926-02-19 |
| Company Identification Number: | 20348 |
| Legal Registered Office Address: |
ATTN: PRESIDENT 585 SCHENECTADY AVENUE BROOKLYN United States of America (USA) 11203 |
More information about KINGSBROOK JEWISH MEDICAL CENTER
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 505 | 2017-06-01 | MICHELE FLOURNOY | |||
| 505 | 2017-06-01 | ||||
| 505 | 2016-06-01 | MICHELE FLOURNOY | |||
| 505 | 2015-06-01 | AMECIA GROOMSTER |
| Measure | Date | Value |
|---|---|---|
| 2017: KINGSBROOK JEWISH MEDICAL CENTER DENTAL INSURANCE PLAN 2017 401k membership | ||
| Total participants, beginning-of-year | 2017-06-01 | 302 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-06-01 | 293 |
| Number of retired or separated participants receiving benefits | 2017-06-01 | 17 |
| Number of other retired or separated participants entitled to future benefits | 2017-06-01 | 0 |
| Total of all active and inactive participants | 2017-06-01 | 310 |
| 2016: KINGSBROOK JEWISH MEDICAL CENTER DENTAL INSURANCE PLAN 2016 401k membership | ||
| Total participants, beginning-of-year | 2016-06-01 | 308 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-06-01 | 313 |
| Number of retired or separated participants receiving benefits | 2016-06-01 | 20 |
| Number of other retired or separated participants entitled to future benefits | 2016-06-01 | 0 |
| Total of all active and inactive participants | 2016-06-01 | 333 |
| 2015: KINGSBROOK JEWISH MEDICAL CENTER DENTAL INSURANCE PLAN 2015 401k membership | ||
| Total participants, beginning-of-year | 2015-06-01 | 224 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-06-01 | 255 |
| Number of retired or separated participants receiving benefits | 2015-06-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2015-06-01 | 0 |
| Total of all active and inactive participants | 2015-06-01 | 255 |
| 2017: KINGSBROOK JEWISH MEDICAL CENTER DENTAL INSURANCE PLAN 2017 form 5500 responses | ||
|---|---|---|
| 2017-06-01 | Type of plan entity | Single employer plan |
| 2017-06-01 | Submission has been amended | No |
| 2017-06-01 | This submission is the final filing | No |
| 2017-06-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2017-06-01 | Plan is a collectively bargained plan | No |
| 2017-06-01 | Plan funding arrangement – Insurance | Yes |
| 2017-06-01 | Plan benefit arrangement – Insurance | Yes |
| 2016: KINGSBROOK JEWISH MEDICAL CENTER DENTAL INSURANCE PLAN 2016 form 5500 responses | ||
| 2016-06-01 | Type of plan entity | Single employer plan |
| 2016-06-01 | Submission has been amended | No |
| 2016-06-01 | This submission is the final filing | No |
| 2016-06-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2016-06-01 | Plan is a collectively bargained plan | No |
| 2016-06-01 | Plan funding arrangement – Insurance | Yes |
| 2016-06-01 | Plan benefit arrangement – Insurance | Yes |
| 2015: KINGSBROOK JEWISH MEDICAL CENTER DENTAL INSURANCE PLAN 2015 form 5500 responses | ||
| 2015-06-01 | Type of plan entity | Single employer plan |
| 2015-06-01 | Submission has been amended | No |
| 2015-06-01 | This submission is the final filing | No |
| 2015-06-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2015-06-01 | Plan is a collectively bargained plan | No |
| 2015-06-01 | Plan funding arrangement – Insurance | Yes |
| 2015-06-01 | Plan benefit arrangement – Insurance | Yes |
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | 0104822 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | 0104822 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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