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PROMISE HEALTHCARE, INC. LIFE CRITICAL INJURY AND SHORT-TERM DISAB PLAN 401k Plan overview

Plan NamePROMISE HEALTHCARE, INC. LIFE CRITICAL INJURY AND SHORT-TERM DISAB PLAN
Plan identification number 509

PROMISE HEALTHCARE, INC. LIFE CRITICAL INJURY AND SHORT-TERM DISAB PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Life insurance
  • Temporary disability (accident and sickness)
  • Long-term disability cover
  • Other welfare benefit cover

401k Sponsoring company profile

PROMISE HEALTHCARE, INC. has sponsored the creation of one or more 401k plans.

Company Name:PROMISE HEALTHCARE, INC.
Employer identification number (EIN):141887953
NAIC Classification:622000
NAIC Description: Hospitals

Additional information about PROMISE HEALTHCARE, INC.

Jurisdiction of Incorporation: Florida Department of State Division of Corporations
Incorporation Date: 2003-05-30
Company Identification Number: P03000059552
Legal Registered Office Address: 1201 HAYS STREET

TALLAHASSEE

32301

More information about PROMISE HEALTHCARE, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan PROMISE HEALTHCARE, INC. LIFE CRITICAL INJURY AND SHORT-TERM DISAB PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5092015-01-01DAVID ARMSTRONG
5092014-01-01DAVID ARMSTRONG
5092013-01-01DAVID J. ARMSTRONG, ESQ.
5092012-01-01DAVID J. ARMSTRONG, ESQ.
5092011-01-01DAVID J. ARMSTRONG, ESQ.
5092009-01-01DAVID ARMSTRONG
5092008-01-01DAVID ARMSTRONG
5092007-06-01DAVID ARMSTRONG

Plan Statistics for PROMISE HEALTHCARE, INC. LIFE CRITICAL INJURY AND SHORT-TERM DISAB PLAN

401k plan membership statisitcs for PROMISE HEALTHCARE, INC. LIFE CRITICAL INJURY AND SHORT-TERM DISAB PLAN

Measure Date Value
2015: PROMISE HEALTHCARE, INC. LIFE CRITICAL INJURY AND SHORT-TERM DISAB PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-01400
Total number of active participants reported on line 7a of the Form 55002015-01-010
Number of retired or separated participants receiving benefits2015-01-010
Number of other retired or separated participants entitled to future benefits2015-01-010
Total of all active and inactive participants2015-01-010
2014: PROMISE HEALTHCARE, INC. LIFE CRITICAL INJURY AND SHORT-TERM DISAB PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-01577
Total number of active participants reported on line 7a of the Form 55002014-01-01400
Number of retired or separated participants receiving benefits2014-01-010
Number of other retired or separated participants entitled to future benefits2014-01-010
Total of all active and inactive participants2014-01-01400
2013: PROMISE HEALTHCARE, INC. LIFE CRITICAL INJURY AND SHORT-TERM DISAB PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-011,100
Total number of active participants reported on line 7a of the Form 55002013-01-01577
Total of all active and inactive participants2013-01-01577
2012: PROMISE HEALTHCARE, INC. LIFE CRITICAL INJURY AND SHORT-TERM DISAB PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-011,898
Total number of active participants reported on line 7a of the Form 55002012-01-011,100
Total of all active and inactive participants2012-01-011,100
2011: PROMISE HEALTHCARE, INC. LIFE CRITICAL INJURY AND SHORT-TERM DISAB PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-012,397
Total number of active participants reported on line 7a of the Form 55002011-01-011,898
Total of all active and inactive participants2011-01-011,898
2009: PROMISE HEALTHCARE, INC. LIFE CRITICAL INJURY AND SHORT-TERM DISAB PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-012,081
Total number of active participants reported on line 7a of the Form 55002009-01-012,117
Total of all active and inactive participants2009-01-012,117
Total participants2009-01-012,117
2008: PROMISE HEALTHCARE, INC. LIFE CRITICAL INJURY AND SHORT-TERM DISAB PLAN 2008 401k membership
Total participants, beginning-of-year2008-01-01954
Total number of active participants reported on line 7a of the Form 55002008-01-012,081
Total of all active and inactive participants2008-01-012,081
Total participants2008-01-012,081
2007: PROMISE HEALTHCARE, INC. LIFE CRITICAL INJURY AND SHORT-TERM DISAB PLAN 2007 401k membership
Total participants, beginning-of-year2007-06-01954
Total number of active participants reported on line 7a of the Form 55002007-06-01954
Total of all active and inactive participants2007-06-01954
Total participants2007-06-01954

Form 5500 Responses for PROMISE HEALTHCARE, INC. LIFE CRITICAL INJURY AND SHORT-TERM DISAB PLAN

2015: PROMISE HEALTHCARE, INC. LIFE CRITICAL INJURY AND SHORT-TERM DISAB PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Submission has been amendedNo
2015-01-01This submission is the final filingYes
2015-01-01This return/report is a short plan year return/report (less than 12 months)Yes
2015-01-01Plan is a collectively bargained planNo
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan benefit arrangement – InsuranceYes
2014: PROMISE HEALTHCARE, INC. LIFE CRITICAL INJURY AND SHORT-TERM DISAB PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Submission has been amendedNo
2014-01-01This submission is the final filingNo
2014-01-01This return/report is a short plan year return/report (less than 12 months)No
2014-01-01Plan is a collectively bargained planNo
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan benefit arrangement – InsuranceYes
2013: PROMISE HEALTHCARE, INC. LIFE CRITICAL INJURY AND SHORT-TERM DISAB PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan funding arrangement – General assets of the sponsorYes
2013-01-01Plan benefit arrangement – InsuranceYes
2013-01-01Plan benefit arrangement – General assets of the sponsorYes
2012: PROMISE HEALTHCARE, INC. LIFE CRITICAL INJURY AND SHORT-TERM DISAB PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan funding arrangement – General assets of the sponsorYes
2012-01-01Plan benefit arrangement – InsuranceYes
2012-01-01Plan benefit arrangement – General assets of the sponsorYes
2011: PROMISE HEALTHCARE, INC. LIFE CRITICAL INJURY AND SHORT-TERM DISAB PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan funding arrangement – General assets of the sponsorYes
2011-01-01Plan benefit arrangement – InsuranceYes
2011-01-01Plan benefit arrangement – General assets of the sponsorYes
2009: PROMISE HEALTHCARE, INC. LIFE CRITICAL INJURY AND SHORT-TERM DISAB PLAN 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Submission has been amendedNo
2009-01-01This submission is the final filingNo
2009-01-01This return/report is a short plan year return/report (less than 12 months)No
2009-01-01Plan is a collectively bargained planNo
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan benefit arrangement – InsuranceYes
2008: PROMISE HEALTHCARE, INC. LIFE CRITICAL INJURY AND SHORT-TERM DISAB PLAN 2008 form 5500 responses
2008-01-01Type of plan entitySingle employer plan
2008-01-01Submission has been amendedNo
2008-01-01This submission is the final filingNo
2008-01-01This return/report is a short plan year return/report (less than 12 months)No
2008-01-01Plan is a collectively bargained planNo
2008-01-01Plan funding arrangement – InsuranceYes
2008-01-01Plan benefit arrangement – InsuranceYes
2007: PROMISE HEALTHCARE, INC. LIFE CRITICAL INJURY AND SHORT-TERM DISAB PLAN 2007 form 5500 responses
2007-06-01Type of plan entitySingle employer plan
2007-06-01First time form 5500 has been submittedYes
2007-06-01Submission has been amendedNo
2007-06-01This submission is the final filingNo
2007-06-01This return/report is a short plan year return/report (less than 12 months)Yes
2007-06-01Plan is a collectively bargained planNo
2007-06-01Plan funding arrangement – InsuranceYes
2007-06-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68195 )
Policy contract number6080394
Policy instance 1
Insurance contract or identification number6080394
Number of Individuals Covered394
Insurance policy start date2014-06-01
Insurance policy end date2015-05-31
Total amount of commissions paid to insurance brokerUSD $8,430
Total amount of fees paid to insurance companyUSD $1,784
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedCRITICAL ILLNESS
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $111,665
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,312
Amount paid for insurance broker fees1784
Additional information about fees paid to insurance brokerADDITIONAL COMPENSATION
Insurance broker organization code?3
Insurance broker nameSTELLA GORDON INC.
PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68195 )
Policy contract number6080394
Policy instance 1
Insurance contract or identification number6080394
Number of Individuals Covered400
Insurance policy start date2014-01-01
Insurance policy end date2014-05-30
Total amount of commissions paid to insurance brokerUSD $2,942
Total amount of fees paid to insurance companyUSD $1,652
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedCRITICAL ILLNESS
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $51,035
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,203
Amount paid for insurance broker fees1652
Additional information about fees paid to insurance brokerADDITIONAL COMPENSATION
Insurance broker organization code?3
Insurance broker nameSTELLA GORDON INC.
PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68195 )
Policy contract number0006080394
Policy instance 1
Insurance contract or identification number0006080394
Number of Individuals Covered577
Insurance policy start date2013-01-01
Insurance policy end date2014-01-01
Total amount of commissions paid to insurance brokerUSD $13,329
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedCRITICAL ILLNESS
Welfare Benefit Premiums Paid to CarrierUSD $190,403
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9,980
Insurance broker organization code?3
Insurance broker name
PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68195 )
Policy contract number0006080394
Policy instance 1
Insurance contract or identification number0006080394
Number of Individuals Covered1100
Insurance policy start date2012-01-01
Insurance policy end date2013-01-01
Total amount of commissions paid to insurance brokerUSD $27,693
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedCRITICAL ILLNESS
Welfare Benefit Premiums Paid to CarrierUSD $211,417
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $21,438
Insurance broker organization code?3
Insurance broker nameLOUIS J PANTALONE C/O CUST BEN PRG
PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68195 )
Policy contract number0006080394
Policy instance 1
Insurance contract or identification number0006080394
Number of Individuals Covered1898
Insurance policy start date2011-01-01
Insurance policy end date2012-01-01
Total amount of commissions paid to insurance brokerUSD $18,398
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedCRITICAL INJURY
Welfare Benefit Premiums Paid to CarrierUSD $225,149
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68195 )
Policy contract number0006080394
Policy instance 1
Insurance contract or identification number0006080394
Number of Individuals Covered2397
Insurance policy start date2010-01-01
Insurance policy end date2011-01-01
Total amount of commissions paid to insurance brokerUSD $52,955
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Other welfare benefits providedCRITICAL INJURY
Welfare Benefit Premiums Paid to CarrierUSD $409,160
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68195 )
Policy contract number0006080394
Policy instance 1
Insurance contract or identification number0006080394
Number of Individuals Covered2081
Insurance policy start date2008-01-01
Insurance policy end date2008-12-31
Total amount of commissions paid to insurance brokerUSD $346,303
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Other welfare benefits providedCRITICAL INJURY
Welfare Benefit Premiums Paid to CarrierUSD $380,913
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68195 )
Policy contract number0006080394
Policy instance 1
Insurance contract or identification number0006080394
Number of Individuals Covered954
Insurance policy start date2007-06-01
Insurance policy end date2007-12-31
Total amount of commissions paid to insurance brokerUSD $27,030
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Other welfare benefits providedCRITICAL INJURY
Welfare Benefit Premiums Paid to CarrierUSD $19,182
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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