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| Plan Name | FALLON COMMUNITY HEALTH PLAN INC. 403 (B) PLAN |
| Plan identification number | 002 |
| 401k Plan Type | Defined Contribution Pension |
| Plan Features/Benefits |
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| 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 |
|---|---|---|---|---|---|
| 002 | 2022-01-01 | JILL LEBOW | 2023-09-22 | JILL LEBOW | 2023-09-22 |
| 002 | 2021-01-01 | JILL LEBOW | 2022-06-30 | JILL LEBOW | 2022-06-30 |
| 002 | 2020-01-01 | JILL LEBOW | 2021-09-24 | JILL LEBOW | 2021-09-24 |
| 002 | 2019-01-01 | JILL LEBOW | 2020-09-25 | JILL LEBOW | 2020-09-25 |
| 002 | 2018-01-01 | JILL LEBOW | 2019-07-16 | JILL LEBOW | 2019-07-16 |
| 002 | 2017-01-01 | JILL LEBOW | 2018-09-26 | JILL LEBOW | 2018-09-26 |
| 002 | 2016-01-01 | RALPH SANTORO | 2017-07-10 | RALPH SANTORO | 2017-07-10 |
| 002 | 2015-01-01 | RALPH SANTORO | 2016-09-06 | RALPH SANTORO | 2016-09-06 |
| 002 | 2015-01-01 | RALPH SANTORO | 2016-09-01 | RALPH SANTORO | 2016-09-01 |
| 002 | 2015-01-01 | RALPH SANTORO | 2016-09-01 | RALPH SANTORO | 2016-09-01 |
| 002 | 2014-01-01 | RALPH SANTORO | 2015-10-09 | RALPH SANTORO | 2015-10-09 |
| 002 | 2013-01-01 | RALPH SANTORO | 2014-10-07 | ||
| 002 | 2012-01-01 | RALPH SANTORO | 2013-07-01 | ||
| 002 | 2011-01-01 | RALPH SANTORO | 2013-06-28 | ||
| 002 | 2010-01-01 | RALPH SANTORO | 2013-06-28 | ||
| 002 | 2009-01-01 | RALPH SANTORO |
| Measure | Date | Value |
|---|---|---|
| 2009: FALLON COMMUNITY HEALTH PLAN INC. 403 (B) PLAN 2009 401k membership | ||
| Total participants, beginning-of-year | 2009-01-01 | 8 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-01-01 | 8 |
| Number of retired or separated participants receiving benefits | 2009-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2009-01-01 | 0 |
| Total of all active and inactive participants | 2009-01-01 | 8 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2009-01-01 | 0 |
| Total participants | 2009-01-01 | 8 |
| Number of participants with account balances | 2009-01-01 | 7 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2009-01-01 | 0 |
| Measure | Date | Value |
|---|---|---|
| 2011 : FALLON COMMUNITY HEALTH PLAN INC. 403 (B) PLAN 2011 401k financial data | ||
| Total income from all sources | 2011-12-31 | $-182 |
| Expenses. Total of all expenses incurred | 2011-12-31 | $10,424 |
| Benefits paid (including direct rollovers) | 2011-12-31 | $10,424 |
| Total plan assets at end of year | 2011-12-31 | $47,608 |
| Total plan assets at beginning of year | 2011-12-31 | $58,214 |
| Other income received | 2011-12-31 | $-182 |
| Net income (gross income less expenses) | 2011-12-31 | $-10,606 |
| Net plan assets at end of year (total assets less liabilities) | 2011-12-31 | $47,608 |
| Net plan assets at beginning of year (total assets less liabilities) | 2011-12-31 | $58,214 |
| 2010 : FALLON COMMUNITY HEALTH PLAN INC. 403 (B) PLAN 2010 401k financial data | ||
| Total income from all sources | 2010-12-31 | $10,955 |
| Expenses. Total of all expenses incurred | 2010-12-31 | $0 |
| Total plan assets at end of year | 2010-12-31 | $58,214 |
| Total plan assets at beginning of year | 2010-12-31 | $47,259 |
| Other income received | 2010-12-31 | $10,955 |
| Net income (gross income less expenses) | 2010-12-31 | $10,955 |
| Net plan assets at end of year (total assets less liabilities) | 2010-12-31 | $58,214 |
| Net plan assets at beginning of year (total assets less liabilities) | 2010-12-31 | $47,259 |
| 2009: FALLON COMMUNITY HEALTH PLAN INC. 403 (B) PLAN 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 – Trust | Yes |
| 2009-01-01 | Plan benefit arrangement - Trust | Yes |
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