401k Plan data: THE MOUNT SINAI MEDICAL CENTER LONG TERM CARE PLAN plan

THE MOUNT SINAI MEDICAL CENTER LONG TERM CARE PLAN 401k Plan overview

Plan Name	THE MOUNT SINAI MEDICAL CENTER LONG TERM CARE PLAN
Plan identification number	519

THE MOUNT SINAI MEDICAL CENTER LONG TERM CARE PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) Other welfare benefit cover

401k Sponsoring company profile

MOUNT SINAI HEALTH SYSTEM has sponsored the creation of one or more 401k plans.

Company Name: MOUNT SINAI HEALTH SYSTEM

Employer identification number (EIN): 131624096

NAIC Classification: 622000
NAIC Description: Hospitals

Additional information about MOUNT SINAI HEALTH SYSTEM

Jurisdiction of Incorporation: New York Department of State

Incorporation Date: 1852-01-16

Company Identification Number: 10128

Legal Registered Office Address: ATTN GENERAL COUNSEL
ONE GUSTAVE L LEVY PLACE
NEW YORK
United States of America (USA)
10029

More information about MOUNT SINAI HEALTH SYSTEM

Form 5500 Filing Information

Submission information for form 5500 for 401k plan THE MOUNT SINAI MEDICAL CENTER LONG TERM CARE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
519 2015-01-01 ROSE MARIE LIGUIGLI
519 2015-01-01 ROSE MARIE LIGUIGLI
519 2014-01-01 PAUL KELLER
519 2013-01-01 PAUL KELLER
519 2012-01-01 PAUL KELLER
519 2011-01-01 PAUL KELLER PAUL KELLER 2012-10-05
519 2009-01-01 PAUL KELLER PAUL KELLER 2010-10-14

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
519	2015-01-01	ROSE MARIE LIGUIGLI
519	2015-01-01	ROSE MARIE LIGUIGLI
519	2014-01-01	PAUL KELLER
519	2013-01-01	PAUL KELLER
519	2012-01-01	PAUL KELLER
519	2011-01-01	PAUL KELLER	PAUL KELLER	2012-10-05
519	2009-01-01	PAUL KELLER	PAUL KELLER	2010-10-14

Plan Statistics for THE MOUNT SINAI MEDICAL CENTER LONG TERM CARE PLAN

401k plan membership statisitcs for THE MOUNT SINAI MEDICAL CENTER LONG TERM CARE PLAN

Measure Date Value
2015: THE MOUNT SINAI MEDICAL CENTER LONG TERM CARE PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 83
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 79
Total of all active and inactive participants 2015-01-01 79
Number of retired or separated participants receiving benefits 2015-01-01 0
Number of other retired or separated participants entitled to future benefits 2015-01-01 0
2014: THE MOUNT SINAI MEDICAL CENTER LONG TERM CARE PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 91
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 86
Total of all active and inactive participants 2014-01-01 86
2013: THE MOUNT SINAI MEDICAL CENTER LONG TERM CARE PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 101
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 96
Total of all active and inactive participants 2013-01-01 96
2012: THE MOUNT SINAI MEDICAL CENTER LONG TERM CARE PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 109
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 105
Total of all active and inactive participants 2012-01-01 105
2011: THE MOUNT SINAI MEDICAL CENTER LONG TERM CARE PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 124
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 119
Total of all active and inactive participants 2011-01-01 119
2009: THE MOUNT SINAI MEDICAL CENTER LONG TERM CARE PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 126
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 132
Number of retired or separated participants receiving benefits 2009-01-01 0
Number of other retired or separated participants entitled to future benefits 2009-01-01 0
Total of all active and inactive participants 2009-01-01 132

Measure	Date	Value
2015: THE MOUNT SINAI MEDICAL CENTER LONG TERM CARE PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	83
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	79
Total of all active and inactive participants	2015-01-01	79
Number of retired or separated participants receiving benefits	2015-01-01	0
Number of other retired or separated participants entitled to future benefits	2015-01-01	0
2014: THE MOUNT SINAI MEDICAL CENTER LONG TERM CARE PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	91
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	86
Total of all active and inactive participants	2014-01-01	86
2013: THE MOUNT SINAI MEDICAL CENTER LONG TERM CARE PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	101
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	96
Total of all active and inactive participants	2013-01-01	96
2012: THE MOUNT SINAI MEDICAL CENTER LONG TERM CARE PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	109
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	105
Total of all active and inactive participants	2012-01-01	105
2011: THE MOUNT SINAI MEDICAL CENTER LONG TERM CARE PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	124
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	119
Total of all active and inactive participants	2011-01-01	119
2009: THE MOUNT SINAI MEDICAL CENTER LONG TERM CARE PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	126
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	132
Number of retired or separated participants receiving benefits	2009-01-01	0
Number of other retired or separated participants entitled to future benefits	2009-01-01	0
Total of all active and inactive participants	2009-01-01	132

Form 5500 Responses for THE MOUNT SINAI MEDICAL CENTER LONG TERM CARE PLAN

2015: THE MOUNT SINAI MEDICAL CENTER LONG TERM CARE PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Submission has been amended	No
2015-01-01	This submission is the final filing	No
2015-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-01-01	Plan is a collectively bargained plan	No
2015-01-01	Plan funding arrangement – Insurance	Yes
2015-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2015-01-01	Plan benefit arrangement – Insurance	Yes
2015-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2014: THE MOUNT SINAI MEDICAL CENTER LONG TERM CARE PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Submission has been amended	No
2014-01-01	This submission is the final filing	No
2014-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-01-01	Plan is a collectively bargained plan	No
2014-01-01	Plan funding arrangement – Insurance	Yes
2014-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes
2014-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2013: THE MOUNT SINAI MEDICAL CENTER LONG TERM CARE PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Submission has been amended	No
2013-01-01	This submission is the final filing	No
2013-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-01-01	Plan is a collectively bargained plan	No
2013-01-01	Plan funding arrangement – Insurance	Yes
2013-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2013-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2012: THE MOUNT SINAI MEDICAL CENTER LONG TERM CARE PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Submission has been amended	No
2012-01-01	This submission is the final filing	No
2012-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-01-01	Plan is a collectively bargained plan	No
2012-01-01	Plan funding arrangement – Insurance	Yes
2012-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2011: THE MOUNT SINAI MEDICAL CENTER LONG TERM CARE PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Submission has been amended	No
2011-01-01	This submission is the final filing	No
2011-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-01-01	Plan is a collectively bargained plan	No
2011-01-01	Plan funding arrangement – Insurance	Yes
2011-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2011-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2009: THE MOUNT SINAI MEDICAL CENTER LONG TERM CARE PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	Submission has been amended	No
2009-01-01	This submission is the final filing	No
2009-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-01-01	Plan is a collectively bargained plan	No
2009-01-01	Plan funding arrangement – Insurance	Yes
2009-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2009-01-01	Plan benefit arrangement – Insurance	Yes
2009-01-01	Plan benefit arrangement – General assets of the sponsor	Yes

Insurance Providers Used on plan

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number	28223
Policy instance	1
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number	28223
Policy instance	1
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number	28223
Policy instance	1
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number	28223
Policy instance	1
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number	28223
Policy instance	1
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number	28223
Policy instance	1

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Company Name:	MOUNT SINAI HEALTH SYSTEM
Employer identification number (EIN):	131624096
NAIC Classification:	622000
NAIC Description:	Hospitals

Jurisdiction of Incorporation:	New York Department of State
Incorporation Date:	1852-01-16
Company Identification Number:	10128
Legal Registered Office Address:	ATTN GENERAL COUNSEL ONE GUSTAVE L LEVY PLACE NEW YORK United States of America (USA) 10029