BLACK RIVER MEDICAL CENTER has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan BLACK RIVER MEDICAL CENTER 401(K)
Measure | Date | Value |
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2014: BLACK RIVER MEDICAL CENTER 401(K) 2014 401k membership |
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Total participants, beginning-of-year | 2014-01-01 | 65 |
Total number of active participants reported on line 7a of the Form 5500 | 2014-01-01 | 63 |
Number of retired or separated participants receiving benefits | 2014-01-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2014-01-01 | 9 |
Total of all active and inactive participants | 2014-01-01 | 72 |
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2014-01-01 | 0 |
Total participants | 2014-01-01 | 72 |
Number of participants with account balances | 2014-01-01 | 43 |
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2014-01-01 | 6 |
2013: BLACK RIVER MEDICAL CENTER 401(K) 2013 401k membership |
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Total participants, beginning-of-year | 2013-01-01 | 72 |
Total number of active participants reported on line 7a of the Form 5500 | 2013-01-01 | 70 |
Number of retired or separated participants receiving benefits | 2013-01-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2013-01-01 | 13 |
Total of all active and inactive participants | 2013-01-01 | 83 |
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2013-01-01 | 0 |
Total participants | 2013-01-01 | 83 |
Number of participants with account balances | 2013-01-01 | 40 |
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2013-01-01 | 5 |
2012: BLACK RIVER MEDICAL CENTER 401(K) 2012 401k membership |
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Total participants, beginning-of-year | 2012-01-01 | 54 |
Total number of active participants reported on line 7a of the Form 5500 | 2012-01-01 | 49 |
Number of retired or separated participants receiving benefits | 2012-01-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2012-01-01 | 12 |
Total of all active and inactive participants | 2012-01-01 | 61 |
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2012-01-01 | 0 |
Total participants | 2012-01-01 | 61 |
Number of participants with account balances | 2012-01-01 | 49 |
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2012-01-01 | 10 |
Measure | Date | Value |
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2014 : BLACK RIVER MEDICAL CENTER 401(K) 2014 401k financial data |
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Transfers to/from the plan | 2014-12-31 | $1,309 |
Total income from all sources | 2014-12-31 | $297,401 |
Expenses. Total of all expenses incurred | 2014-12-31 | $134,869 |
Benefits paid (including direct rollovers) | 2014-12-31 | $112,674 |
Total plan assets at end of year | 2014-12-31 | $1,991,485 |
Total plan assets at beginning of year | 2014-12-31 | $1,827,644 |
Value of fidelity bond covering the plan | 2014-12-31 | $200,000 |
Total contributions received or receivable from participants | 2014-12-31 | $160,281 |
Expenses. Other expenses not covered elsewhere | 2014-12-31 | $236 |
Contributions received from other sources (not participants or employers) | 2014-12-31 | $0 |
Other income received | 2014-12-31 | $71,976 |
Net income (gross income less expenses) | 2014-12-31 | $162,532 |
Net plan assets at end of year (total assets less liabilities) | 2014-12-31 | $1,991,485 |
Net plan assets at beginning of year (total assets less liabilities) | 2014-12-31 | $1,827,644 |
Assets. Value of participant loans | 2014-12-31 | $28,329 |
Total contributions received or receivable from employer(s) | 2014-12-31 | $65,144 |
Value of certain deemed distributions of participant loans | 2014-12-31 | $0 |
Value of corrective distributions | 2014-12-31 | $21,959 |
Funding deficiency by the employer to the plan for this plan year | 2014-12-31 | $0 |
Minimum employer required contribution for this plan year | 2014-12-31 | $0 |
Amount contributed by the employer to the plan for this plan year | 2014-12-31 | $0 |
2013 : BLACK RIVER MEDICAL CENTER 401(K) 2013 401k financial data |
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Transfers to/from the plan | 2013-12-31 | $0 |
Total income from all sources | 2013-12-31 | $495,005 |
Expenses. Total of all expenses incurred | 2013-12-31 | $21,941 |
Benefits paid (including direct rollovers) | 2013-12-31 | $18,523 |
Total plan assets at end of year | 2013-12-31 | $1,827,644 |
Total plan assets at beginning of year | 2013-12-31 | $1,354,580 |
Value of fidelity bond covering the plan | 2013-12-31 | $200,000 |
Total contributions received or receivable from participants | 2013-12-31 | $153,945 |
Expenses. Other expenses not covered elsewhere | 2013-12-31 | $125 |
Contributions received from other sources (not participants or employers) | 2013-12-31 | $0 |
Other income received | 2013-12-31 | $288,362 |
Net income (gross income less expenses) | 2013-12-31 | $473,064 |
Net plan assets at end of year (total assets less liabilities) | 2013-12-31 | $1,827,644 |
Net plan assets at beginning of year (total assets less liabilities) | 2013-12-31 | $1,354,580 |
Assets. Value of participant loans | 2013-12-31 | $0 |
Total contributions received or receivable from employer(s) | 2013-12-31 | $52,698 |
Value of certain deemed distributions of participant loans | 2013-12-31 | $0 |
Value of corrective distributions | 2013-12-31 | $3,293 |
Funding deficiency by the employer to the plan for this plan year | 2013-12-31 | $0 |
Minimum employer required contribution for this plan year | 2013-12-31 | $0 |
Amount contributed by the employer to the plan for this plan year | 2013-12-31 | $0 |
2012 : BLACK RIVER MEDICAL CENTER 401(K) 2012 401k financial data |
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Transfers to/from the plan | 2012-12-31 | $0 |
Total income from all sources | 2012-12-31 | $345,585 |
Expenses. Total of all expenses incurred | 2012-12-31 | $95,997 |
Benefits paid (including direct rollovers) | 2012-12-31 | $95,897 |
Total plan assets at end of year | 2012-12-31 | $1,354,580 |
Total plan assets at beginning of year | 2012-12-31 | $1,104,992 |
Value of fidelity bond covering the plan | 2012-12-31 | $200,000 |
Total contributions received or receivable from participants | 2012-12-31 | $130,917 |
Expenses. Other expenses not covered elsewhere | 2012-12-31 | $100 |
Contributions received from other sources (not participants or employers) | 2012-12-31 | $0 |
Other income received | 2012-12-31 | $167,019 |
Net income (gross income less expenses) | 2012-12-31 | $249,588 |
Net plan assets at end of year (total assets less liabilities) | 2012-12-31 | $1,354,580 |
Net plan assets at beginning of year (total assets less liabilities) | 2012-12-31 | $1,104,992 |
Assets. Value of participant loans | 2012-12-31 | $0 |
Total contributions received or receivable from employer(s) | 2012-12-31 | $47,649 |
Value of certain deemed distributions of participant loans | 2012-12-31 | $0 |
Value of corrective distributions | 2012-12-31 | $0 |
Funding deficiency by the employer to the plan for this plan year | 2012-12-31 | $0 |
Minimum employer required contribution for this plan year | 2012-12-31 | $0 |
Amount contributed by the employer to the plan for this plan year | 2012-12-31 | $0 |
2014: BLACK RIVER MEDICAL CENTER 401(K) 2014 form 5500 responses |
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2014-01-01 | Type of plan entity | Single employer plan |
2014-01-01 | Submission has been amended | No |
2014-01-01 | This submission is the final filing | No |
2014-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2014-01-01 | Plan is a collectively bargained plan | No |
2014-01-01 | Plan funding arrangement – Insurance | Yes |
2014-01-01 | Plan funding arrangement – Trust | Yes |
2014-01-01 | Plan benefit arrangement – Insurance | Yes |
2013: BLACK RIVER MEDICAL CENTER 401(K) 2013 form 5500 responses |
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2013-01-01 | Type of plan entity | Single employer plan |
2013-01-01 | Submission has been amended | No |
2013-01-01 | This submission is the final filing | No |
2013-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2013-01-01 | Plan is a collectively bargained plan | No |
2013-01-01 | Plan funding arrangement – Insurance | Yes |
2013-01-01 | Plan funding arrangement – Trust | Yes |
2013-01-01 | Plan benefit arrangement – Insurance | Yes |
2012: BLACK RIVER MEDICAL CENTER 401(K) 2012 form 5500 responses |
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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 | No |
2012-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
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 |
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 ) |
Policy contract number | GA-824404 |
Policy instance | 1 |
Insurance contract or identification number | GA-824404 | Number of Individuals Covered | 43 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Total amount of commissions paid to insurance broker | USD $7,256 | Total amount of fees paid to insurance company | USD $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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | 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 Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | 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 | Commission paid to Insurance Broker | USD $7,256 | Insurance broker organization code? | 3 | Insurance broker name | SBHU LIFE AGENCY INC |
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HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 ) |
Policy contract number | GA-824404 |
Policy instance | 1 |
Insurance contract or identification number | GA-824404 | Number of Individuals Covered | 40 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Total amount of commissions paid to insurance broker | USD $5,819 | Total amount of fees paid to insurance company | USD $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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | 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 Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | 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 | Commission paid to Insurance Broker | USD $5,819 | Insurance broker organization code? | 3 | Insurance broker name | SBHU LIFE AGCY INC |
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HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 ) |
Policy contract number | GA-824404 |
Policy instance | 1 |
Insurance contract or identification number | GA-824404 | Number of Individuals Covered | 49 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Total amount of commissions paid to insurance broker | USD $3,723 | Total amount of fees paid to insurance company | USD $107 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | 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 Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | 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 | Commission paid to Insurance Broker | USD $3,723 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 82 | Additional information about fees paid to insurance broker | SALES/MARKETING | Insurance broker name | MORGANSTANLEY SMITHBARNEY LLC |
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