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RETIREMENT PLAN FOR EMPLOYEES OF FALLON COMMUNITY HEALTH PLAN, INC. 401k Plan overview

Plan NameRETIREMENT PLAN FOR EMPLOYEES OF FALLON COMMUNITY HEALTH PLAN, INC.
Plan identification number 001

RETIREMENT PLAN FOR EMPLOYEES OF FALLON COMMUNITY HEALTH PLAN, INC. Benefits

401k Plan TypeDefined Benefit Pension
Plan Features/Benefits
  • Benefits are primarily pay related
  • Covered by PBGC - Plan is covered under the PBGC insurance program (see ERISA section 4021).
  • Plan sponsor(s) is (are) a member(s) of a controlled group (Code sections 414(b), (c), or (m)).

401k Sponsoring company profile

FALLON COMMUNITY HEALTH PLAN has sponsored the creation of one or more 401k plans.

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

Form 5500 Filing Information

Submission information for form 5500 for 401k plan RETIREMENT PLAN FOR EMPLOYEES OF FALLON COMMUNITY HEALTH PLAN, INC.

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012012-01-01RALPH SANTORO RALPH SANTORO2013-07-03
0012011-01-01RALPH SANTORO
0012010-01-01RALPH SANTORO
0012009-01-01RALPH SANTORO

Plan Statistics for RETIREMENT PLAN FOR EMPLOYEES OF FALLON COMMUNITY HEALTH PLAN, INC.

401k plan membership statisitcs for RETIREMENT PLAN FOR EMPLOYEES OF FALLON COMMUNITY HEALTH PLAN, INC.

Measure Date Value
2012: RETIREMENT PLAN FOR EMPLOYEES OF FALLON COMMUNITY HEALTH PLAN, INC. 2012 401k membership
Total participants, beginning-of-year2012-01-010
Total number of active participants reported on line 7a of the Form 55002012-01-010
Number of retired or separated participants receiving benefits2012-01-010
Number of other retired or separated participants entitled to future benefits2012-01-010
Total of all active and inactive participants2012-01-010
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-01-010
Total participants2012-01-010
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-01-010
2011: RETIREMENT PLAN FOR EMPLOYEES OF FALLON COMMUNITY HEALTH PLAN, INC. 2011 401k membership
Total participants, beginning-of-year2011-01-01603
Total number of active participants reported on line 7a of the Form 55002011-01-01272
Number of retired or separated participants receiving benefits2011-01-0116
Number of other retired or separated participants entitled to future benefits2011-01-01298
Total of all active and inactive participants2011-01-01586
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2011-01-010
Total participants2011-01-01586
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2011-01-010
2010: RETIREMENT PLAN FOR EMPLOYEES OF FALLON COMMUNITY HEALTH PLAN, INC. 2010 401k membership
Total participants, beginning-of-year2010-01-01620
Total number of active participants reported on line 7a of the Form 55002010-01-01302
Number of retired or separated participants receiving benefits2010-01-017
Number of other retired or separated participants entitled to future benefits2010-01-01294
Total of all active and inactive participants2010-01-01603
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2010-01-010
Total participants2010-01-01603
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2010-01-010
2009: RETIREMENT PLAN FOR EMPLOYEES OF FALLON COMMUNITY HEALTH PLAN, INC. 2009 401k membership
Total participants, beginning-of-year2009-01-01657
Total number of active participants reported on line 7a of the Form 55002009-01-01335
Number of retired or separated participants receiving benefits2009-01-013
Number of other retired or separated participants entitled to future benefits2009-01-01282
Total of all active and inactive participants2009-01-01620
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2009-01-010
Total participants2009-01-01620
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2009-01-011

Financial Data on RETIREMENT PLAN FOR EMPLOYEES OF FALLON COMMUNITY HEALTH PLAN, INC.

Measure Date Value
2012 : RETIREMENT PLAN FOR EMPLOYEES OF FALLON COMMUNITY HEALTH PLAN, INC. 2012 401k financial data
Total unrealized appreciation/depreciation of assets2012-12-13$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 assets2012-12-13$0
Total of all expenses incurred2012-12-13$33,362,666
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2012-12-13$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 year2012-12-13$0
Value of total assets at beginning of year2012-12-13$25,694,621
Total of administrative expenses incurred including professional, contract, advisory and management fees2012-12-13$26,639
Total interest from all sources2012-12-13$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 year2012-12-13Yes
Was this plan covered by a fidelity bond2012-12-13Yes
Value of fidelity bond cover2012-12-13$1,000,000
If this is an individual account plan, was there a blackout period2012-12-13No
Were there any nonexempt tranactions with any party-in-interest2012-12-13No
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 appraiser2012-12-13No
Income. Non cash contributions2012-12-13$3,332
Value of net income/loss2012-12-13$-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)2012-12-13No
Were any loans by the plan or fixed income obligations due to the plan in default2012-12-13No
Were any leases to which the plan was party in default or uncollectible2012-12-13No
Value of interest in pooled separate accounts at end of year2012-12-13$0
Value of interest in pooled separate accounts at beginning of year2012-12-13$25,694,621
Net investment gain/loss from pooled separate accounts2012-12-13$399,713
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2012-12-13Yes
Was there a failure to transmit to the plan any participant contributions2012-12-13No
Has the plan failed to provide any benefit when due under the plan2012-12-13No
Contributions received in cash from employer2012-12-13$7,265,000
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2012-12-13$22,187,699
Contract administrator fees2012-12-13$26,639
Did the plan have assets held for investment2012-12-13No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-13No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2012-12-13Yes
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2012-12-13Yes
Opinion of an independent qualified public accountant for this plan2012-12-13Disclaimer
Accountancy firm name2012-12-13ERNST AND YOUNG
Accountancy firm EIN2012-12-13346565596
2011 : RETIREMENT PLAN FOR EMPLOYEES OF FALLON COMMUNITY HEALTH PLAN, INC. 2011 401k financial data
Total unrealized appreciation/depreciation of assets2011-12-31$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 assets2011-12-31$0
Total of all expenses incurred2011-12-31$717,140
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2011-12-31$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 year2011-12-31$25,694,621
Value of total assets at beginning of year2011-12-31$21,925,196
Total of administrative expenses incurred including professional, contract, advisory and management fees2011-12-31$22,899
Total interest from all sources2011-12-31$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 year2011-12-31No
Was this plan covered by a fidelity bond2011-12-31Yes
Value of fidelity bond cover2011-12-31$1,000,000
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2011-12-31$0
Were there any nonexempt tranactions with any party-in-interest2011-12-31No
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 appraiser2011-12-31No
Value of net income/loss2011-12-31$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)2011-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2011-12-31No
Were any leases to which the plan was party in default or uncollectible2011-12-31No
Value of interest in pooled separate accounts at end of year2011-12-31$25,694,621
Value of interest in pooled separate accounts at beginning of year2011-12-31$21,925,196
Net investment gain/loss from pooled separate accounts2011-12-31$4,278,865
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2011-12-31Yes
Was there a failure to transmit to the plan any participant contributions2011-12-31No
Has the plan failed to provide any benefit when due under the plan2011-12-31No
Contributions received in cash from employer2011-12-31$207,700
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2011-12-31$673,136
Contract administrator fees2011-12-31$22,899
Did the plan have assets held for investment2011-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2011-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2011-12-31Yes
Opinion of an independent qualified public accountant for this plan2011-12-31Disclaimer
Accountancy firm name2011-12-31ERNST AND YOUNG
Accountancy firm EIN2011-12-31346565596
2010 : RETIREMENT PLAN FOR EMPLOYEES OF FALLON COMMUNITY HEALTH PLAN, INC. 2010 401k financial data
Total unrealized appreciation/depreciation of assets2010-12-31$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 assets2010-12-31$0
Total of all expenses incurred2010-12-31$741,020
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2010-12-31$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 year2010-12-31$21,925,196
Value of total assets at beginning of year2010-12-31$19,095,689
Total of administrative expenses incurred including professional, contract, advisory and management fees2010-12-31$22,645
Total interest from all sources2010-12-31$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 year2010-12-31No
Was this plan covered by a fidelity bond2010-12-31Yes
Value of fidelity bond cover2010-12-31$1,000,000
Were there any nonexempt tranactions with any party-in-interest2010-12-31No
Income. Received or receivable in cash from other sources (including rollovers)2010-12-31$2,586
Administrative expenses (other) incurred2010-12-31$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 appraiser2010-12-31No
Value of net income/loss2010-12-31$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)2010-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2010-12-31No
Were any leases to which the plan was party in default or uncollectible2010-12-31No
Value of interest in pooled separate accounts at end of year2010-12-31$21,925,196
Value of interest in pooled separate accounts at beginning of year2010-12-31$19,095,689
Net investment gain/loss from pooled separate accounts2010-12-31$2,679,337
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2010-12-31No
Was there a failure to transmit to the plan any participant contributions2010-12-31No
Has the plan failed to provide any benefit when due under the plan2010-12-31No
Contributions received in cash from employer2010-12-31$888,604
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2010-12-31$718,375
Did the plan have assets held for investment2010-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2010-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2010-12-31Yes
Opinion of an independent qualified public accountant for this plan2010-12-31Disclaimer
Accountancy firm name2010-12-31ERNST AND YOUNG
Accountancy firm EIN2010-12-31346565596

Form 5500 Responses for RETIREMENT PLAN FOR EMPLOYEES OF FALLON COMMUNITY HEALTH PLAN, INC.

2012: RETIREMENT PLAN FOR EMPLOYEES OF FALLON COMMUNITY HEALTH PLAN, INC. 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Submission has been amendedNo
2012-01-01This submission is the final filingYes
2012-01-01This return/report is a short plan year return/report (less than 12 months)Yes
2012-01-01Plan is a collectively bargained planNo
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan funding arrangement – TrustYes
2012-01-01Plan benefit arrangement – InsuranceYes
2012-01-01Plan benefit arrangement - TrustYes
2011: RETIREMENT PLAN FOR EMPLOYEES OF FALLON COMMUNITY HEALTH PLAN, INC. 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Submission has been amendedNo
2011-01-01This submission is the final filingNo
2011-01-01This return/report is a short plan year return/report (less than 12 months)No
2011-01-01Plan is a collectively bargained planNo
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan funding arrangement – TrustYes
2011-01-01Plan benefit arrangement – InsuranceYes
2011-01-01Plan benefit arrangement - TrustYes
2010: RETIREMENT PLAN FOR EMPLOYEES OF FALLON COMMUNITY HEALTH PLAN, INC. 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01Submission has been amendedNo
2010-01-01This submission is the final filingNo
2010-01-01This return/report is a short plan year return/report (less than 12 months)No
2010-01-01Plan is a collectively bargained planNo
2010-01-01Plan funding arrangement – InsuranceYes
2010-01-01Plan funding arrangement – TrustYes
2010-01-01Plan benefit arrangement – InsuranceYes
2010-01-01Plan benefit arrangement - TrustYes
2009: RETIREMENT PLAN FOR EMPLOYEES OF FALLON COMMUNITY HEALTH PLAN, INC. 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 funding arrangement – TrustYes
2009-01-01Plan benefit arrangement – InsuranceYes
2009-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )
Policy contract numberSA 12884
Policy instance 1
Insurance contract or identification numberSA 12884
Number of Individuals Covered0
Insurance policy start date2012-01-01
Insurance policy end date2012-12-13
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
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?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )
Policy contract numberSA 12884
Policy instance 1
Insurance contract or identification numberSA 12884
Number of Individuals Covered586
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
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?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )
Policy contract numberSA 12884
Policy instance 1
Insurance contract or identification numberSA 12884
Number of Individuals Covered603
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
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?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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