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| Plan Name | GROVE CITY MEDICAL CENTER WELFARE BENEFIT PLAN |
| Plan identification number | 561 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | GROVE CITY MEDICAL CENTER |
| Employer identification number (EIN): | 251340370 |
| NAIC Classification: | 622000 |
| NAIC Description: | Hospitals |
Additional information about GROVE CITY MEDICAL CENTER
| Jurisdiction of Incorporation: | COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF STATE |
| Incorporation Date: | |
| Company Identification Number: | 664102 |
More information about GROVE CITY MEDICAL CENTER
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 561 | 2022-01-01 | ||||
| 561 | 2021-01-01 |
| Measure | Date | Value |
|---|---|---|
| 2022: GROVE CITY MEDICAL CENTER WELFARE BENEFIT PLAN 2022 401k membership | ||
| Total participants, beginning-of-year | 2022-01-01 | 223 |
| Total number of active participants reported on line 7a of the Form 5500 | 2022-01-01 | 240 |
| Number of retired or separated participants receiving benefits | 2022-01-01 | 3 |
| Total of all active and inactive participants | 2022-01-01 | 243 |
| Total participants | 2022-01-01 | 243 |
| 2021: GROVE CITY MEDICAL CENTER WELFARE BENEFIT PLAN 2021 401k membership | ||
| Total participants, beginning-of-year | 2021-01-01 | 240 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-01-01 | 221 |
| Number of retired or separated participants receiving benefits | 2021-01-01 | 2 |
| Total of all active and inactive participants | 2021-01-01 | 223 |
| Total participants | 2021-01-01 | 223 |
| 2022: GROVE CITY MEDICAL CENTER WELFARE BENEFIT PLAN 2022 form 5500 responses | ||
|---|---|---|
| 2022-01-01 | Type of plan entity | Single employer plan |
| 2022-01-01 | Submission has been amended | No |
| 2022-01-01 | This submission is the final filing | No |
| 2022-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2022-01-01 | Plan is a collectively bargained plan | No |
| 2022-01-01 | Plan funding arrangement – Insurance | Yes |
| 2022-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2022-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2022-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2021: GROVE CITY MEDICAL CENTER WELFARE BENEFIT PLAN 2021 form 5500 responses | ||
| 2021-01-01 | Type of plan entity | Single employer plan |
| 2021-01-01 | Submission has been amended | No |
| 2021-01-01 | This submission is the final filing | No |
| 2021-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2021-01-01 | Plan is a collectively bargained plan | No |
| 2021-01-01 | Plan funding arrangement – Insurance | Yes |
| 2021-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2021-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2021-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| MAGELLAN HEALTH SERVICES (National Association of Insurance Commissioners NAIC id number: 00000 ) | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | WPAH-0-005 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | 54310 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 2 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| SECURIAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93742 ) | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | 70063 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 3 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| MAGELLAN HEALTH SERVICES (National Association of Insurance Commissioners NAIC id number: 00000 ) | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | WPAH0-005 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | 54310 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 2 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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