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GROUP LONG-TERM DISABILITY & GROUP LIFE & AD&D BENEFITS FOR PLAN II AND III EMPLOYEES 401k Plan overview

Plan NameGROUP LONG-TERM DISABILITY & GROUP LIFE & AD&D BENEFITS FOR PLAN II AND III EMPLOYEES
Plan identification number 506

GROUP LONG-TERM DISABILITY & GROUP LIFE & AD&D BENEFITS FOR PLAN II AND III EMPLOYEES 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

J.C. BLAIR MEMORIAL HOSPITAL has sponsored the creation of one or more 401k plans.

Company Name:J.C. BLAIR MEMORIAL HOSPITAL
Employer identification number (EIN):231352159
NAIC Classification:622000
NAIC Description: Hospitals

Additional information about J.C. BLAIR MEMORIAL HOSPITAL

Jurisdiction of Incorporation: COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF STATE
Incorporation Date:
Company Identification Number: 38355

More information about J.C. BLAIR MEMORIAL HOSPITAL

Form 5500 Filing Information

Submission information for form 5500 for 401k plan GROUP LONG-TERM DISABILITY & GROUP LIFE & AD&D BENEFITS FOR PLAN II AND III EMPLOYEES

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5062020-06-02
5062019-06-02
5062018-06-02
5062017-06-02JEFF TRAPP JEFF TRAPP2019-03-08
5062016-06-02JEFF TRAPP JEFF TRAPP2018-02-16
5062015-06-02DEBORAH SHUGHART DEBORAH SHUGHART2017-03-13
5062014-06-02DEBORAH SHUGHART DEBORAH SHUGHART2016-03-14
5062013-06-02DEBORAH SHUGHART DEBORAH SHUGHART2015-03-12
5062012-06-02EDWARD M. QUINN EDWARD M. QUINN2014-03-10
5062011-06-02EDWARD M. QUINN EDWARD M. QUINN2013-03-12
5062010-06-02MICHAEL H. WIDENER MICHAEL H. WIDENER2012-03-13
5062009-06-02NANCY GLIDDEN NANCY GLIDDEN2011-03-14

Plan Statistics for GROUP LONG-TERM DISABILITY & GROUP LIFE & AD&D BENEFITS FOR PLAN II AND III EMPLOYEES

401k plan membership statisitcs for GROUP LONG-TERM DISABILITY & GROUP LIFE & AD&D BENEFITS FOR PLAN II AND III EMPLOYEES

Measure Date Value
2020: GROUP LONG-TERM DISABILITY & GROUP LIFE & AD&D BENEFITS FOR PLAN II AND III EMPLOYEES 2020 401k membership
Total participants, beginning-of-year2020-06-02220
Total number of active participants reported on line 7a of the Form 55002020-06-02219
Total of all active and inactive participants2020-06-02219
2019: GROUP LONG-TERM DISABILITY & GROUP LIFE & AD&D BENEFITS FOR PLAN II AND III EMPLOYEES 2019 401k membership
Total participants, beginning-of-year2019-06-02256
Total number of active participants reported on line 7a of the Form 55002019-06-02220
Total of all active and inactive participants2019-06-02220
2018: GROUP LONG-TERM DISABILITY & GROUP LIFE & AD&D BENEFITS FOR PLAN II AND III EMPLOYEES 2018 401k membership
Total participants, beginning-of-year2018-06-02328
Total number of active participants reported on line 7a of the Form 55002018-06-02256
Total of all active and inactive participants2018-06-02256
2017: GROUP LONG-TERM DISABILITY & GROUP LIFE & AD&D BENEFITS FOR PLAN II AND III EMPLOYEES 2017 401k membership
Total participants, beginning-of-year2017-06-02390
Total number of active participants reported on line 7a of the Form 55002017-06-02390
Total of all active and inactive participants2017-06-02390
2016: GROUP LONG-TERM DISABILITY & GROUP LIFE & AD&D BENEFITS FOR PLAN II AND III EMPLOYEES 2016 401k membership
Total participants, beginning-of-year2016-06-02262
Total number of active participants reported on line 7a of the Form 55002016-06-02390
Total of all active and inactive participants2016-06-02390
2015: GROUP LONG-TERM DISABILITY & GROUP LIFE & AD&D BENEFITS FOR PLAN II AND III EMPLOYEES 2015 401k membership
Total participants, beginning-of-year2015-06-02288
Total number of active participants reported on line 7a of the Form 55002015-06-02262
Total of all active and inactive participants2015-06-02262
2014: GROUP LONG-TERM DISABILITY & GROUP LIFE & AD&D BENEFITS FOR PLAN II AND III EMPLOYEES 2014 401k membership
Total participants, beginning-of-year2014-06-02233
Total number of active participants reported on line 7a of the Form 55002014-06-02288
Total of all active and inactive participants2014-06-02288
2013: GROUP LONG-TERM DISABILITY & GROUP LIFE & AD&D BENEFITS FOR PLAN II AND III EMPLOYEES 2013 401k membership
Total participants, beginning-of-year2013-06-02232
Total number of active participants reported on line 7a of the Form 55002013-06-02233
Total of all active and inactive participants2013-06-02233
2012: GROUP LONG-TERM DISABILITY & GROUP LIFE & AD&D BENEFITS FOR PLAN II AND III EMPLOYEES 2012 401k membership
Total participants, beginning-of-year2012-06-02232
Total number of active participants reported on line 7a of the Form 55002012-06-02232
Total of all active and inactive participants2012-06-02232
2011: GROUP LONG-TERM DISABILITY & GROUP LIFE & AD&D BENEFITS FOR PLAN II AND III EMPLOYEES 2011 401k membership
Total participants, beginning-of-year2011-06-02243
Total number of active participants reported on line 7a of the Form 55002011-06-02232
Total of all active and inactive participants2011-06-02232
2010: GROUP LONG-TERM DISABILITY & GROUP LIFE & AD&D BENEFITS FOR PLAN II AND III EMPLOYEES 2010 401k membership
Total participants, beginning-of-year2010-06-02427
Total number of active participants reported on line 7a of the Form 55002010-06-02243
Total of all active and inactive participants2010-06-02243
2009: GROUP LONG-TERM DISABILITY & GROUP LIFE & AD&D BENEFITS FOR PLAN II AND III EMPLOYEES 2009 401k membership
Total participants, beginning-of-year2009-06-02400
Total number of active participants reported on line 7a of the Form 55002009-06-02427
Total of all active and inactive participants2009-06-02427

Form 5500 Responses for GROUP LONG-TERM DISABILITY & GROUP LIFE & AD&D BENEFITS FOR PLAN II AND III EMPLOYEES

2020: GROUP LONG-TERM DISABILITY & GROUP LIFE & AD&D BENEFITS FOR PLAN II AND III EMPLOYEES 2020 form 5500 responses
2020-06-02Type of plan entitySingle employer plan
2020-06-02Plan is a collectively bargained planYes
2020-06-02Plan funding arrangement – InsuranceYes
2020-06-02Plan benefit arrangement – InsuranceYes
2019: GROUP LONG-TERM DISABILITY & GROUP LIFE & AD&D BENEFITS FOR PLAN II AND III EMPLOYEES 2019 form 5500 responses
2019-06-02Type of plan entitySingle employer plan
2019-06-02Plan is a collectively bargained planYes
2019-06-02Plan funding arrangement – InsuranceYes
2019-06-02Plan benefit arrangement – InsuranceYes
2018: GROUP LONG-TERM DISABILITY & GROUP LIFE & AD&D BENEFITS FOR PLAN II AND III EMPLOYEES 2018 form 5500 responses
2018-06-02Type of plan entitySingle employer plan
2018-06-02Plan is a collectively bargained planYes
2018-06-02Plan funding arrangement – InsuranceYes
2018-06-02Plan benefit arrangement – InsuranceYes
2017: GROUP LONG-TERM DISABILITY & GROUP LIFE & AD&D BENEFITS FOR PLAN II AND III EMPLOYEES 2017 form 5500 responses
2017-06-02Type of plan entitySingle employer plan
2017-06-02Plan is a collectively bargained planYes
2017-06-02Plan funding arrangement – InsuranceYes
2017-06-02Plan benefit arrangement – InsuranceYes
2016: GROUP LONG-TERM DISABILITY & GROUP LIFE & AD&D BENEFITS FOR PLAN II AND III EMPLOYEES 2016 form 5500 responses
2016-06-02Type of plan entitySingle employer plan
2016-06-02Plan is a collectively bargained planYes
2016-06-02Plan funding arrangement – InsuranceYes
2016-06-02Plan benefit arrangement – InsuranceYes
2015: GROUP LONG-TERM DISABILITY & GROUP LIFE & AD&D BENEFITS FOR PLAN II AND III EMPLOYEES 2015 form 5500 responses
2015-06-02Type of plan entitySingle employer plan
2015-06-02Plan is a collectively bargained planYes
2015-06-02Plan funding arrangement – InsuranceYes
2015-06-02Plan benefit arrangement – InsuranceYes
2014: GROUP LONG-TERM DISABILITY & GROUP LIFE & AD&D BENEFITS FOR PLAN II AND III EMPLOYEES 2014 form 5500 responses
2014-06-02Type of plan entitySingle employer plan
2014-06-02Plan is a collectively bargained planYes
2014-06-02Plan funding arrangement – InsuranceYes
2014-06-02Plan benefit arrangement – InsuranceYes
2013: GROUP LONG-TERM DISABILITY & GROUP LIFE & AD&D BENEFITS FOR PLAN II AND III EMPLOYEES 2013 form 5500 responses
2013-06-02Type of plan entitySingle employer plan
2013-06-02Plan is a collectively bargained planYes
2013-06-02Plan funding arrangement – InsuranceYes
2013-06-02Plan benefit arrangement – InsuranceYes
2012: GROUP LONG-TERM DISABILITY & GROUP LIFE & AD&D BENEFITS FOR PLAN II AND III EMPLOYEES 2012 form 5500 responses
2012-06-02Type of plan entitySingle employer plan
2012-06-02Plan is a collectively bargained planYes
2012-06-02Plan funding arrangement – InsuranceYes
2012-06-02Plan benefit arrangement – InsuranceYes
2011: GROUP LONG-TERM DISABILITY & GROUP LIFE & AD&D BENEFITS FOR PLAN II AND III EMPLOYEES 2011 form 5500 responses
2011-06-02Type of plan entitySingle employer plan
2011-06-02Plan is a collectively bargained planYes
2011-06-02Plan funding arrangement – InsuranceYes
2011-06-02Plan benefit arrangement – InsuranceYes
2010: GROUP LONG-TERM DISABILITY & GROUP LIFE & AD&D BENEFITS FOR PLAN II AND III EMPLOYEES 2010 form 5500 responses
2010-06-02Type of plan entitySingle employer plan
2010-06-02Plan is a collectively bargained planYes
2010-06-02Plan funding arrangement – InsuranceYes
2010-06-02Plan benefit arrangement – InsuranceYes
2009: GROUP LONG-TERM DISABILITY & GROUP LIFE & AD&D BENEFITS FOR PLAN II AND III EMPLOYEES 2009 form 5500 responses
2009-06-02Type of plan entitySingle employer plan
2009-06-02This submission is the final filingNo
2009-06-02Plan is a collectively bargained planYes
2009-06-02Plan funding arrangement – InsuranceYes
2009-06-02Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberVAR 672906
Policy instance 4
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberG 670385
Policy instance 3
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberLTD 669884
Policy instance 2
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberGL 668923
Policy instance 1
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberVAR 672906
Policy instance 4
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberG 670385
Policy instance 3
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberLTD 669884
Policy instance 2
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberGL 668923
Policy instance 1
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberVAR 672906
Policy instance 4
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberGL 668923
Policy instance 1
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberLTD 669884
Policy instance 2
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberG 670385
Policy instance 3
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberVAR 672906
Policy instance 4
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberG 670385
Policy instance 3
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberLTD 669884
Policy instance 2
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberGL 668923
Policy instance 1
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberGL 668923
Policy instance 1
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberG 670385
Policy instance 3
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberLTD 669884
Policy instance 2
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberVAR 672906
Policy instance 4
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberGL 668923
Policy instance 1
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberVAR 672906
Policy instance 4
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberG 670385
Policy instance 3
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberLTD 669884
Policy instance 2
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberVAR 672906
Policy instance 4
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberLTD 669884
Policy instance 2
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberGL 668923
Policy instance 1
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberG 670385
Policy instance 3
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberGL 668923
Policy instance 1
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberVAR 672906
Policy instance 4
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberG 670385
Policy instance 3
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberLTD 669884
Policy instance 2
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberLTD 669884
Policy instance 2
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberGL 668923
Policy instance 1
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberGL 668923
Policy instance 2
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number881829
Policy instance 1
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberLTD 669884
Policy instance 3

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