| Plan Name | RETIREMENT PLAN FOR EMPLOYEES OF FALLON COMMUNITY HEALTH PLAN, INC. |
| Plan identification number | 001 |
| 401k Plan Type | Defined Benefit Pension |
| Plan Features/Benefits |
|
| Company Name: | FALLON COMMUNITY HEALTH PLAN |
| Employer identification number (EIN): | 237442369 |
| NAIC Classification: | 621399 |
| NAIC Description: | Offices of All Other Miscellaneous Health Practitioners |
Additional information about FALLON COMMUNITY HEALTH PLAN
| Jurisdiction of Incorporation: | Virginia Secretary of State |
| Incorporation Date: | 2011-11-04 |
| Company Identification Number: | F187885 |
| Legal Registered Office Address: |
100 SHOCKOE SLIP 2ND FLOOR RICHMOND United States of America (USA) 23219 |
More information about FALLON COMMUNITY HEALTH PLAN
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 001 | 2012-01-01 | RALPH SANTORO | RALPH SANTORO | 2013-07-03 | |
| 001 | 2011-01-01 | RALPH SANTORO | |||
| 001 | 2010-01-01 | RALPH SANTORO | |||
| 001 | 2009-01-01 | RALPH SANTORO |
| Measure | Date | Value |
|---|---|---|
| 2012 : RETIREMENT PLAN FOR EMPLOYEES OF FALLON COMMUNITY HEALTH PLAN, INC. 2012 401k financial data | ||
| Total unrealized appreciation/depreciation of assets | 2012-12-13 | $0 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2012-12-13 | $0 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2012-12-13 | $0 |
| Total income from all sources (including contributions) | 2012-12-13 | $7,668,045 |
| Total loss/gain on sale of assets | 2012-12-13 | $0 |
| Total of all expenses incurred | 2012-12-13 | $33,362,666 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2012-12-13 | $33,336,027 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2012-12-13 | $7,268,332 |
| Value of total assets at end of year | 2012-12-13 | $0 |
| Value of total assets at beginning of year | 2012-12-13 | $25,694,621 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2012-12-13 | $26,639 |
| Total interest from all sources | 2012-12-13 | $0 |
| Total dividends received (eg from common stock, registered investment company shares) | 2012-12-13 | $0 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2012-12-13 | Yes |
| Was this plan covered by a fidelity bond | 2012-12-13 | Yes |
| Value of fidelity bond cover | 2012-12-13 | $1,000,000 |
| If this is an individual account plan, was there a blackout period | 2012-12-13 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2012-12-13 | No |
| Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries) | 2012-12-13 | $11,148,328 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2012-12-13 | No |
| Income. Non cash contributions | 2012-12-13 | $3,332 |
| Value of net income/loss | 2012-12-13 | $-25,694,621 |
| Value of net assets at end of year (total assets less liabilities) | 2012-12-13 | $0 |
| Value of net assets at beginning of year (total assets less liabilities) | 2012-12-13 | $25,694,621 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2012-12-13 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2012-12-13 | No |
| Were any leases to which the plan was party in default or uncollectible | 2012-12-13 | No |
| Value of interest in pooled separate accounts at end of year | 2012-12-13 | $0 |
| Value of interest in pooled separate accounts at beginning of year | 2012-12-13 | $25,694,621 |
| Net investment gain/loss from pooled separate accounts | 2012-12-13 | $399,713 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2012-12-13 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2012-12-13 | No |
| Has the plan failed to provide any benefit when due under the plan | 2012-12-13 | No |
| Contributions received in cash from employer | 2012-12-13 | $7,265,000 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2012-12-13 | $22,187,699 |
| Contract administrator fees | 2012-12-13 | $26,639 |
| Did the plan have assets held for investment | 2012-12-13 | No |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2012-12-13 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2012-12-13 | Yes |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2012-12-13 | Yes |
| Opinion of an independent qualified public accountant for this plan | 2012-12-13 | Disclaimer |
| Accountancy firm name | 2012-12-13 | ERNST AND YOUNG |
| Accountancy firm EIN | 2012-12-13 | 346565596 |
| 2011 : RETIREMENT PLAN FOR EMPLOYEES OF FALLON COMMUNITY HEALTH PLAN, INC. 2011 401k financial data | ||
| Total unrealized appreciation/depreciation of assets | 2011-12-31 | $0 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2011-12-31 | $0 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2011-12-31 | $0 |
| Total income from all sources (including contributions) | 2011-12-31 | $4,486,565 |
| Total loss/gain on sale of assets | 2011-12-31 | $0 |
| Total of all expenses incurred | 2011-12-31 | $717,140 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2011-12-31 | $694,241 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2011-12-31 | $207,700 |
| Value of total assets at end of year | 2011-12-31 | $25,694,621 |
| Value of total assets at beginning of year | 2011-12-31 | $21,925,196 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2011-12-31 | $22,899 |
| Total interest from all sources | 2011-12-31 | $0 |
| Total dividends received (eg from common stock, registered investment company shares) | 2011-12-31 | $0 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2011-12-31 | No |
| Was this plan covered by a fidelity bond | 2011-12-31 | Yes |
| Value of fidelity bond cover | 2011-12-31 | $1,000,000 |
| Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities | 2011-12-31 | $0 |
| Were there any nonexempt tranactions with any party-in-interest | 2011-12-31 | No |
| Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries) | 2011-12-31 | $21,105 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2011-12-31 | No |
| Value of net income/loss | 2011-12-31 | $3,769,425 |
| Value of net assets at end of year (total assets less liabilities) | 2011-12-31 | $25,694,621 |
| Value of net assets at beginning of year (total assets less liabilities) | 2011-12-31 | $21,925,196 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2011-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2011-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2011-12-31 | No |
| Value of interest in pooled separate accounts at end of year | 2011-12-31 | $25,694,621 |
| Value of interest in pooled separate accounts at beginning of year | 2011-12-31 | $21,925,196 |
| Net investment gain/loss from pooled separate accounts | 2011-12-31 | $4,278,865 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2011-12-31 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2011-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2011-12-31 | No |
| Contributions received in cash from employer | 2011-12-31 | $207,700 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2011-12-31 | $673,136 |
| Contract administrator fees | 2011-12-31 | $22,899 |
| Did the plan have assets held for investment | 2011-12-31 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2011-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2011-12-31 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2011-12-31 | Yes |
| Opinion of an independent qualified public accountant for this plan | 2011-12-31 | Disclaimer |
| Accountancy firm name | 2011-12-31 | ERNST AND YOUNG |
| Accountancy firm EIN | 2011-12-31 | 346565596 |
| 2010 : RETIREMENT PLAN FOR EMPLOYEES OF FALLON COMMUNITY HEALTH PLAN, INC. 2010 401k financial data | ||
| Total unrealized appreciation/depreciation of assets | 2010-12-31 | $0 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2010-12-31 | $0 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2010-12-31 | $0 |
| Total income from all sources (including contributions) | 2010-12-31 | $3,570,527 |
| Total loss/gain on sale of assets | 2010-12-31 | $0 |
| Total of all expenses incurred | 2010-12-31 | $741,020 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2010-12-31 | $718,375 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2010-12-31 | $891,190 |
| Value of total assets at end of year | 2010-12-31 | $21,925,196 |
| Value of total assets at beginning of year | 2010-12-31 | $19,095,689 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2010-12-31 | $22,645 |
| Total interest from all sources | 2010-12-31 | $0 |
| Total dividends received (eg from common stock, registered investment company shares) | 2010-12-31 | $0 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2010-12-31 | No |
| Was this plan covered by a fidelity bond | 2010-12-31 | Yes |
| Value of fidelity bond cover | 2010-12-31 | $1,000,000 |
| Were there any nonexempt tranactions with any party-in-interest | 2010-12-31 | No |
| Income. Received or receivable in cash from other sources (including rollovers) | 2010-12-31 | $2,586 |
| Administrative expenses (other) incurred | 2010-12-31 | $22,645 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2010-12-31 | No |
| Value of net income/loss | 2010-12-31 | $2,829,507 |
| Value of net assets at end of year (total assets less liabilities) | 2010-12-31 | $21,925,196 |
| Value of net assets at beginning of year (total assets less liabilities) | 2010-12-31 | $19,095,689 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2010-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2010-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2010-12-31 | No |
| Value of interest in pooled separate accounts at end of year | 2010-12-31 | $21,925,196 |
| Value of interest in pooled separate accounts at beginning of year | 2010-12-31 | $19,095,689 |
| Net investment gain/loss from pooled separate accounts | 2010-12-31 | $2,679,337 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2010-12-31 | No |
| Was there a failure to transmit to the plan any participant contributions | 2010-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2010-12-31 | No |
| Contributions received in cash from employer | 2010-12-31 | $888,604 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2010-12-31 | $718,375 |
| Did the plan have assets held for investment | 2010-12-31 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2010-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2010-12-31 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2010-12-31 | Yes |
| Opinion of an independent qualified public accountant for this plan | 2010-12-31 | Disclaimer |
| Accountancy firm name | 2010-12-31 | ERNST AND YOUNG |
| Accountancy firm EIN | 2010-12-31 | 346565596 |
| 2012: RETIREMENT PLAN FOR EMPLOYEES OF FALLON COMMUNITY HEALTH PLAN, INC. 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 | Yes |
| 2012-01-01 | This return/report is a short plan year return/report (less than 12 months) | Yes |
| 2012-01-01 | Plan is a collectively bargained plan | No |
| 2012-01-01 | Plan funding arrangement – Insurance | Yes |
| 2012-01-01 | Plan funding arrangement – Trust | Yes |
| 2012-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2012-01-01 | Plan benefit arrangement - Trust | Yes |
| 2011: RETIREMENT PLAN FOR EMPLOYEES OF FALLON COMMUNITY HEALTH PLAN, INC. 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 – Trust | Yes |
| 2011-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2011-01-01 | Plan benefit arrangement - Trust | Yes |
| 2010: RETIREMENT PLAN FOR EMPLOYEES OF FALLON COMMUNITY HEALTH PLAN, INC. 2010 form 5500 responses | ||
| 2010-01-01 | Type of plan entity | Single employer plan |
| 2010-01-01 | Submission has been amended | No |
| 2010-01-01 | This submission is the final filing | No |
| 2010-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2010-01-01 | Plan is a collectively bargained plan | No |
| 2010-01-01 | Plan funding arrangement – Insurance | Yes |
| 2010-01-01 | Plan funding arrangement – Trust | Yes |
| 2010-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2010-01-01 | Plan benefit arrangement - Trust | Yes |
| 2009: RETIREMENT PLAN FOR EMPLOYEES OF FALLON COMMUNITY HEALTH PLAN, INC. 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 – Trust | Yes |
| 2009-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2009-01-01 | Plan benefit arrangement - Trust | Yes |
| MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 ) | |
| Policy contract number | SA 12884 |
| Policy instance | 1 |
| MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 ) | |
| Policy contract number | SA 12884 |
| Policy instance | 1 |
| MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 ) | |
| Policy contract number | SA 12884 |
| Policy instance | 1 |