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LEGACY HEALTH SYSTEM WELFARE BENEFITS PLAN UNFUNDED 401k Plan overview

Plan NameLEGACY HEALTH SYSTEM WELFARE BENEFITS PLAN UNFUNDED
Plan identification number 504

LEGACY HEALTH SYSTEM WELFARE BENEFITS PLAN UNFUNDED Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Vision
  • Temporary disability (accident and sickness)
  • Long-term disability cover
  • Severance pay
  • Death benefits (include travel accident but not life insurance)

401k Sponsoring company profile

LEGACY HEALTH has sponsored the creation of one or more 401k plans.

Company Name:LEGACY HEALTH
Employer identification number (EIN):237426300
NAIC Classification:622000
NAIC Description: Hospitals

Form 5500 Filing Information

Submission information for form 5500 for 401k plan LEGACY HEALTH SYSTEM WELFARE BENEFITS PLAN UNFUNDED

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5042024-01-01LISA J. GOREN
5042023-01-01
5042023-01-01LISA J. GOREN
5042022-01-01
5042022-01-01LISA J. GOREN
5042021-01-01
5042021-01-01LISA J. GOREN
5042020-01-01
5042019-01-01
5042017-01-01SONJA O. STEVES
5042016-01-01SONJA O. STEVES
5042015-01-01SONJA O. STEVES
5042014-01-01SONJA O. STEVES
5042013-01-01SONJA O. STEVES
5042012-01-01SONJA O. STEVES
5042011-01-01SONJA O STEVES
5042009-01-01SONJA O STEVES PAMELA S VUKOVICH2010-10-14
5042009-01-01SONJA O STEVES PAMELA S VUKOVICH2010-10-14
5042009-01-01SONJA O STEVES
5042009-01-01SONJA O STEVES

Plan Statistics for LEGACY HEALTH SYSTEM WELFARE BENEFITS PLAN UNFUNDED

401k plan membership statisitcs for LEGACY HEALTH SYSTEM WELFARE BENEFITS PLAN UNFUNDED

Measure Date Value
2023: LEGACY HEALTH SYSTEM WELFARE BENEFITS PLAN UNFUNDED 2023 401k membership
Total participants, beginning-of-year2023-01-0112,903
Total number of active participants reported on line 7a of the Form 55002023-01-0112,977
Total of all active and inactive participants2023-01-0112,977
Total participants2023-01-0112,977
2022: LEGACY HEALTH SYSTEM WELFARE BENEFITS PLAN UNFUNDED 2022 401k membership
Total participants, beginning-of-year2022-01-0112,254
Total number of active participants reported on line 7a of the Form 55002022-01-0112,903
Total of all active and inactive participants2022-01-0112,903
Total participants2022-01-0112,903
2021: LEGACY HEALTH SYSTEM WELFARE BENEFITS PLAN UNFUNDED 2021 401k membership
Total participants, beginning-of-year2021-01-0112,200
Total number of active participants reported on line 7a of the Form 55002021-01-0112,254
Total of all active and inactive participants2021-01-0112,254
Total participants2021-01-0112,254
2020: LEGACY HEALTH SYSTEM WELFARE BENEFITS PLAN UNFUNDED 2020 401k membership
Total participants, beginning-of-year2020-01-0112,230
Total number of active participants reported on line 7a of the Form 55002020-01-0112,200
Total of all active and inactive participants2020-01-0112,200
Total participants2020-01-0112,200
2019: LEGACY HEALTH SYSTEM WELFARE BENEFITS PLAN UNFUNDED 2019 401k membership
Total participants, beginning-of-year2019-01-0112,298
Total number of active participants reported on line 7a of the Form 55002019-01-0112,230
Total of all active and inactive participants2019-01-0112,230
Total participants2019-01-0112,230
2017: LEGACY HEALTH SYSTEM WELFARE BENEFITS PLAN UNFUNDED 2017 401k membership
Total participants, beginning-of-year2017-01-0111,549
Total number of active participants reported on line 7a of the Form 55002017-01-0112,146
Total of all active and inactive participants2017-01-0112,146
Total participants2017-01-0112,146
2016: LEGACY HEALTH SYSTEM WELFARE BENEFITS PLAN UNFUNDED 2016 401k membership
Total participants, beginning-of-year2016-01-019,937
Total number of active participants reported on line 7a of the Form 55002016-01-0110,545
Total of all active and inactive participants2016-01-0110,545
Total participants2016-01-0110,545
2015: LEGACY HEALTH SYSTEM WELFARE BENEFITS PLAN UNFUNDED 2015 401k membership
Total participants, beginning-of-year2015-01-019,278
Total number of active participants reported on line 7a of the Form 55002015-01-019,901
Total of all active and inactive participants2015-01-019,901
Total participants2015-01-010
2014: LEGACY HEALTH SYSTEM WELFARE BENEFITS PLAN UNFUNDED 2014 401k membership
Total participants, beginning-of-year2014-01-018,863
Total number of active participants reported on line 7a of the Form 55002014-01-019,220
Total of all active and inactive participants2014-01-019,220
Total participants2014-01-010
2013: LEGACY HEALTH SYSTEM WELFARE BENEFITS PLAN UNFUNDED 2013 401k membership
Total participants, beginning-of-year2013-01-018,363
Total number of active participants reported on line 7a of the Form 55002013-01-018,771
Total of all active and inactive participants2013-01-018,771
Total participants2013-01-010
2012: LEGACY HEALTH SYSTEM WELFARE BENEFITS PLAN UNFUNDED 2012 401k membership
Total participants, beginning-of-year2012-01-018,414
Total number of active participants reported on line 7a of the Form 55002012-01-018,363
Total of all active and inactive participants2012-01-018,363
Total participants2012-01-010
2011: LEGACY HEALTH SYSTEM WELFARE BENEFITS PLAN UNFUNDED 2011 401k membership
Total participants, beginning-of-year2011-01-018,400
Total number of active participants reported on line 7a of the Form 55002011-01-018,414
Total of all active and inactive participants2011-01-018,414
Total participants2011-01-018,414
2009: LEGACY HEALTH SYSTEM WELFARE BENEFITS PLAN UNFUNDED 2009 401k membership
Total participants, beginning-of-year2009-01-018,254
Total number of active participants reported on line 7a of the Form 55002009-01-018,358
Total of all active and inactive participants2009-01-018,358
Total participants2009-01-018,358

Form 5500 Responses for LEGACY HEALTH SYSTEM WELFARE BENEFITS PLAN UNFUNDED

2023: LEGACY HEALTH SYSTEM WELFARE BENEFITS PLAN UNFUNDED 2023 form 5500 responses
2023-01-01Type of plan entitySingle employer plan
2023-01-01Plan funding arrangement – General assets of the sponsorYes
2023-01-01Plan benefit arrangement – InsuranceYes
2023-01-01Plan benefit arrangement – General assets of the sponsorYes
2022: LEGACY HEALTH SYSTEM WELFARE BENEFITS PLAN UNFUNDED 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Plan funding arrangement – General assets of the sponsorYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement – General assets of the sponsorYes
2021: LEGACY HEALTH SYSTEM WELFARE BENEFITS PLAN UNFUNDED 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Plan funding arrangement – General assets of the sponsorYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement – General assets of the sponsorYes
2020: LEGACY HEALTH SYSTEM WELFARE BENEFITS PLAN UNFUNDED 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Plan funding arrangement – General assets of the sponsorYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement – General assets of the sponsorYes
2019: LEGACY HEALTH SYSTEM WELFARE BENEFITS PLAN UNFUNDED 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Plan funding arrangement – General assets of the sponsorYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement – General assets of the sponsorYes
2017: LEGACY HEALTH SYSTEM WELFARE BENEFITS PLAN UNFUNDED 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Plan funding arrangement – General assets of the sponsorYes
2017-01-01Plan benefit arrangement – InsuranceYes
2017-01-01Plan benefit arrangement – General assets of the sponsorYes
2016: LEGACY HEALTH SYSTEM WELFARE BENEFITS PLAN UNFUNDED 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Plan funding arrangement – General assets of the sponsorYes
2016-01-01Plan benefit arrangement – InsuranceYes
2016-01-01Plan benefit arrangement – General assets of the sponsorYes
2015: LEGACY HEALTH SYSTEM WELFARE BENEFITS PLAN UNFUNDED 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Plan funding arrangement – General assets of the sponsorYes
2015-01-01Plan benefit arrangement – InsuranceYes
2015-01-01Plan benefit arrangement – General assets of the sponsorYes
2014: LEGACY HEALTH SYSTEM WELFARE BENEFITS PLAN UNFUNDED 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Plan funding arrangement – General assets of the sponsorYes
2014-01-01Plan benefit arrangement – InsuranceYes
2014-01-01Plan benefit arrangement – General assets of the sponsorYes
2013: LEGACY HEALTH SYSTEM WELFARE BENEFITS PLAN UNFUNDED 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
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: LEGACY HEALTH SYSTEM WELFARE BENEFITS PLAN UNFUNDED 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
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: LEGACY HEALTH SYSTEM WELFARE BENEFITS PLAN UNFUNDED 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Submission has been amendedYes
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: LEGACY HEALTH SYSTEM WELFARE BENEFITS PLAN UNFUNDED 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Plan funding arrangement – General assets of the sponsorYes
2009-01-01Plan benefit arrangement – InsuranceYes
2009-01-01Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

ARAG INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 34738 )
Policy contract number18939-0001-001
Policy instance 6
Insurance contract or identification number18939-0001-001
Number of Individuals Covered2554
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $33,895
Other welfare benefits providedLEGAL INSURANCE
Welfare Benefit Premiums Paid to CarrierUSD $249,633
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 62146 )
Policy contract numberLBT
Policy instance 5
Insurance contract or identification numberLBT
Number of Individuals Covered1484
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $239,608
Other welfare benefits providedLONG TERM CARE & LIFE INSURANCE
Welfare Benefit Premiums Paid to CarrierUSD $1,153,779
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CONTINENTAL AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71730 )
Policy contract number0000025867
Policy instance 4
Insurance contract or identification number0000025867
Number of Individuals Covered5073
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $434,096
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,276,970
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 19682 )
Policy contract numberGTA101277
Policy instance 3
Insurance contract or identification numberGTA101277
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $2,832
Total amount of fees paid to insurance companyUSD $3,210
Other welfare benefits providedBUSINESS TRAVEL ACCIDENT
Welfare Benefit Premiums Paid to CarrierUSD $18,883
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract numberADDS07955
Policy instance 2
Insurance contract or identification numberADDS07955
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $11,251
Total amount of fees paid to insurance companyUSD $3,292
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $416,349
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number675851-0GL
Policy instance 1
Insurance contract or identification number675851-0GL
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $113,293
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $4,547,262
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number675851-0GL
Policy instance 1
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract numberADDS07955
Policy instance 2
HARTFORD LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 19682 )
Policy contract numberGTA101277
Policy instance 3
CONTINENTAL AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71730 )
Policy contract number0000025867
Policy instance 4
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 62146 )
Policy contract numberLBT
Policy instance 5
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 62146 )
Policy contract numberLBT
Policy instance 5
CONTINENTAL AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71730 )
Policy contract number0000025867
Policy instance 4
HARTFORD LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 19682 )
Policy contract numberGTA101277
Policy instance 3
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract numberADDS07955
Policy instance 2
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number675851-0GL
Policy instance 1
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number675851-0GL
Policy instance 1
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract numberADDS07955
Policy instance 2
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGTA101277
Policy instance 3
CONTINENTAL AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71730 )
Policy contract number0000025867
Policy instance 4
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract numberETB114035
Policy instance 3
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract numberADDS07955
Policy instance 2
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number675851-0GL
Policy instance 1
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract numberETB114035
Policy instance 3
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract numberADDS07955
Policy instance 2
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number675851-0GL
Policy instance 1

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