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HEALTH INSURANCE ACCIDENT & SICKNESS 401k Plan overview

Plan NameHEALTH INSURANCE ACCIDENT & SICKNESS
Plan identification number 509

HEALTH INSURANCE ACCIDENT & SICKNESS Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)

401k Sponsoring company profile

SURGICAL APPLIANCE INDUSTRIES, INC. has sponsored the creation of one or more 401k plans.

Company Name:SURGICAL APPLIANCE INDUSTRIES, INC.
Employer identification number (EIN):310397670
NAIC Classification:339110

Form 5500 Filing Information

Submission information for form 5500 for 401k plan HEALTH INSURANCE ACCIDENT & SICKNESS

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5092022-10-01
5092022-10-01JEFF CHILDS
5092021-10-01
5092021-10-01JEFF CHILDS
5092020-10-01
5092019-10-01
5092016-07-01JEFF CHILDS JEFF CHILDS2018-04-12
5092015-07-01JEFF CHILDS JEFF CHILDS2017-04-17
5092014-07-01JEFF CHILDS JEFF CHILDS2016-04-14
5092013-07-01JEFF CHILDS JEFF CHILDS2015-04-09
5092012-07-01JEFF CHILDS JEFF CHILDS2014-04-09
5092011-07-01JEFF CHILDS JEFF CHILDS2013-04-10
5092009-07-01JEFF CHILDS
5092009-07-01 JEFF CHILDS2011-04-14

Plan Statistics for HEALTH INSURANCE ACCIDENT & SICKNESS

401k plan membership statisitcs for HEALTH INSURANCE ACCIDENT & SICKNESS

Measure Date Value
2022: HEALTH INSURANCE ACCIDENT & SICKNESS 2022 401k membership
Total participants, beginning-of-year2022-10-0174
Total number of active participants reported on line 7a of the Form 55002022-10-0168
Total of all active and inactive participants2022-10-0168
Total participants2022-10-0168
2021: HEALTH INSURANCE ACCIDENT & SICKNESS 2021 401k membership
Total participants, beginning-of-year2021-10-0178
Total number of active participants reported on line 7a of the Form 55002021-10-0170
Total of all active and inactive participants2021-10-0170
Total participants2021-10-0170
2020: HEALTH INSURANCE ACCIDENT & SICKNESS 2020 401k membership
Total participants, beginning-of-year2020-10-0183
Total number of active participants reported on line 7a of the Form 55002020-10-0173
Total of all active and inactive participants2020-10-0173
Total participants2020-10-0173
2019: HEALTH INSURANCE ACCIDENT & SICKNESS 2019 401k membership
Total participants, beginning-of-year2019-10-0187
Total number of active participants reported on line 7a of the Form 55002019-10-0183
Total of all active and inactive participants2019-10-0183
Total participants2019-10-0183
2016: HEALTH INSURANCE ACCIDENT & SICKNESS 2016 401k membership
Total participants, beginning-of-year2016-07-0146
Total number of active participants reported on line 7a of the Form 55002016-07-0154
Total of all active and inactive participants2016-07-0154
Total participants2016-07-0154
2015: HEALTH INSURANCE ACCIDENT & SICKNESS 2015 401k membership
Total participants, beginning-of-year2015-07-0128
Total number of active participants reported on line 7a of the Form 55002015-07-0146
Total of all active and inactive participants2015-07-0146
Total participants2015-07-0146
2014: HEALTH INSURANCE ACCIDENT & SICKNESS 2014 401k membership
Total participants, beginning-of-year2014-07-0127
Total number of active participants reported on line 7a of the Form 55002014-07-0126
Total of all active and inactive participants2014-07-0126
Total participants2014-07-0126
2013: HEALTH INSURANCE ACCIDENT & SICKNESS 2013 401k membership
Total participants, beginning-of-year2013-07-0125
Total number of active participants reported on line 7a of the Form 55002013-07-0123
Total of all active and inactive participants2013-07-0123
Total participants2013-07-0123
2012: HEALTH INSURANCE ACCIDENT & SICKNESS 2012 401k membership
Total participants, beginning-of-year2012-07-0128
Total number of active participants reported on line 7a of the Form 55002012-07-0125
Total of all active and inactive participants2012-07-0125
Total participants2012-07-0125
2011: HEALTH INSURANCE ACCIDENT & SICKNESS 2011 401k membership
Total participants, beginning-of-year2011-07-0137
Total number of active participants reported on line 7a of the Form 55002011-07-0132
Total of all active and inactive participants2011-07-0132
Total participants2011-07-0132
2009: HEALTH INSURANCE ACCIDENT & SICKNESS 2009 401k membership
Total participants, beginning-of-year2009-07-0149
Total number of active participants reported on line 7a of the Form 55002009-07-0141
Total of all active and inactive participants2009-07-0141
Total participants2009-07-0141

Financial Data on HEALTH INSURANCE ACCIDENT & SICKNESS

Measure Date Value
2023 : HEALTH INSURANCE ACCIDENT & SICKNESS 2023 401k financial data
Total income from all sources2023-09-30$464,673
Expenses. Total of all expenses incurred2023-09-30$464,673
Benefits paid (including direct rollovers)2023-09-30$464,673
Total contributions received or receivable from participants2023-09-30$278,912
Net income (gross income less expenses)2023-09-30$0
Total contributions received or receivable from employer(s)2023-09-30$185,761
2022 : HEALTH INSURANCE ACCIDENT & SICKNESS 2022 401k financial data
Total income from all sources2022-09-30$483,896
Expenses. Total of all expenses incurred2022-09-30$483,896
Benefits paid (including direct rollovers)2022-09-30$483,896
Total contributions received or receivable from participants2022-09-30$240,160
Net income (gross income less expenses)2022-09-30$0
Total contributions received or receivable from employer(s)2022-09-30$243,736
2021 : HEALTH INSURANCE ACCIDENT & SICKNESS 2021 401k financial data
Total income from all sources2021-09-30$495,487
Expenses. Total of all expenses incurred2021-09-30$495,487
Benefits paid (including direct rollovers)2021-09-30$495,487
Total contributions received or receivable from participants2021-09-30$250,805
Net income (gross income less expenses)2021-09-30$0
Total contributions received or receivable from employer(s)2021-09-30$244,682
2020 : HEALTH INSURANCE ACCIDENT & SICKNESS 2020 401k financial data
Total income from all sources2020-09-30$540,249
Expenses. Total of all expenses incurred2020-09-30$540,249
Benefits paid (including direct rollovers)2020-09-30$540,249
Total contributions received or receivable from participants2020-09-30$259,689
Net income (gross income less expenses)2020-09-30$0
Total contributions received or receivable from employer(s)2020-09-30$280,560
2019 : HEALTH INSURANCE ACCIDENT & SICKNESS 2019 401k financial data
Total income from all sources2019-09-30$549,609
Expenses. Total of all expenses incurred2019-09-30$549,609
Benefits paid (including direct rollovers)2019-09-30$549,609
Total contributions received or receivable from participants2019-09-30$269,969
Net income (gross income less expenses)2019-09-30$0
Total contributions received or receivable from employer(s)2019-09-30$279,640
2017 : HEALTH INSURANCE ACCIDENT & SICKNESS 2017 401k financial data
Total income from all sources2017-06-30$378,517
Expenses. Total of all expenses incurred2017-06-30$378,517
Benefits paid (including direct rollovers)2017-06-30$378,517
Total contributions received or receivable from participants2017-06-30$185,576
Net income (gross income less expenses)2017-06-30$0
Net plan assets at end of year (total assets less liabilities)2017-06-30$0
Net plan assets at beginning of year (total assets less liabilities)2017-06-30$0
Total contributions received or receivable from employer(s)2017-06-30$192,941
2016 : HEALTH INSURANCE ACCIDENT & SICKNESS 2016 401k financial data
Total income from all sources2016-06-30$291,662
Expenses. Total of all expenses incurred2016-06-30$291,662
Benefits paid (including direct rollovers)2016-06-30$291,662
Total contributions received or receivable from participants2016-06-30$157,152
Net income (gross income less expenses)2016-06-30$0
Total contributions received or receivable from employer(s)2016-06-30$134,510
2015 : HEALTH INSURANCE ACCIDENT & SICKNESS 2015 401k financial data
Total income from all sources2015-06-30$219,318
Expenses. Total of all expenses incurred2015-06-30$219,318
Benefits paid (including direct rollovers)2015-06-30$219,318
Total contributions received or receivable from participants2015-06-30$151,284
Net income (gross income less expenses)2015-06-30$0
Total contributions received or receivable from employer(s)2015-06-30$68,034
2014 : HEALTH INSURANCE ACCIDENT & SICKNESS 2014 401k financial data
Total income from all sources2014-06-30$196,702
Expenses. Total of all expenses incurred2014-06-30$196,702
Benefits paid (including direct rollovers)2014-06-30$196,702
Value of fidelity bond covering the plan2014-06-30$50,000
Total contributions received or receivable from participants2014-06-30$137,184
Net income (gross income less expenses)2014-06-30$0
Total contributions received or receivable from employer(s)2014-06-30$59,518
2013 : HEALTH INSURANCE ACCIDENT & SICKNESS 2013 401k financial data
Total income from all sources2013-06-30$229,527
Expenses. Total of all expenses incurred2013-06-30$0
Benefits paid (including direct rollovers)2013-06-30$229,527
Value of fidelity bond covering the plan2013-06-30$50,000
Total contributions received or receivable from participants2013-06-30$163,763
Net income (gross income less expenses)2013-06-30$229,527
Total contributions received or receivable from employer(s)2013-06-30$65,764
2012 : HEALTH INSURANCE ACCIDENT & SICKNESS 2012 401k financial data
Total income from all sources2012-06-30$265,504
Value of fidelity bond covering the plan2012-06-30$50,000
Total contributions received or receivable from participants2012-06-30$195,797
Net income (gross income less expenses)2012-06-30$265,504
Total contributions received or receivable from employer(s)2012-06-30$69,707
2011 : HEALTH INSURANCE ACCIDENT & SICKNESS 2011 401k financial data
Total income from all sources2011-06-30$289,525
Expenses. Total of all expenses incurred2011-06-30$289,525
Benefits paid (including direct rollovers)2011-06-30$289,525
Value of fidelity bond covering the plan2011-06-30$50,000
Total contributions received or receivable from participants2011-06-30$221,869
Net income (gross income less expenses)2011-06-30$0
Total contributions received or receivable from employer(s)2011-06-30$67,656

Form 5500 Responses for HEALTH INSURANCE ACCIDENT & SICKNESS

2022: HEALTH INSURANCE ACCIDENT & SICKNESS 2022 form 5500 responses
2022-10-01Type of plan entitySingle employer plan
2022-10-01Submission has been amendedNo
2022-10-01This submission is the final filingNo
2022-10-01This return/report is a short plan year return/report (less than 12 months)No
2022-10-01Plan is a collectively bargained planNo
2022-10-01Plan funding arrangement – InsuranceYes
2022-10-01Plan benefit arrangement – InsuranceYes
2021: HEALTH INSURANCE ACCIDENT & SICKNESS 2021 form 5500 responses
2021-10-01Type of plan entitySingle employer plan
2021-10-01Submission has been amendedNo
2021-10-01This submission is the final filingNo
2021-10-01This return/report is a short plan year return/report (less than 12 months)No
2021-10-01Plan is a collectively bargained planNo
2021-10-01Plan funding arrangement – InsuranceYes
2021-10-01Plan benefit arrangement – InsuranceYes
2020: HEALTH INSURANCE ACCIDENT & SICKNESS 2020 form 5500 responses
2020-10-01Type of plan entitySingle employer plan
2020-10-01Submission has been amendedNo
2020-10-01This submission is the final filingNo
2020-10-01This return/report is a short plan year return/report (less than 12 months)No
2020-10-01Plan is a collectively bargained planNo
2020-10-01Plan funding arrangement – InsuranceYes
2020-10-01Plan benefit arrangement – InsuranceYes
2019: HEALTH INSURANCE ACCIDENT & SICKNESS 2019 form 5500 responses
2019-10-01Type of plan entitySingle employer plan
2019-10-01Submission has been amendedNo
2019-10-01This submission is the final filingNo
2019-10-01This return/report is a short plan year return/report (less than 12 months)No
2019-10-01Plan is a collectively bargained planNo
2019-10-01Plan funding arrangement – InsuranceYes
2019-10-01Plan benefit arrangement – InsuranceYes
2016: HEALTH INSURANCE ACCIDENT & SICKNESS 2016 form 5500 responses
2016-07-01Type of plan entitySingle employer plan
2016-07-01Submission has been amendedNo
2016-07-01This submission is the final filingNo
2016-07-01This return/report is a short plan year return/report (less than 12 months)No
2016-07-01Plan is a collectively bargained planNo
2016-07-01Plan funding arrangement – InsuranceYes
2016-07-01Plan benefit arrangement – InsuranceYes
2015: HEALTH INSURANCE ACCIDENT & SICKNESS 2015 form 5500 responses
2015-07-01Type of plan entitySingle employer plan
2015-07-01Submission has been amendedNo
2015-07-01This submission is the final filingNo
2015-07-01This return/report is a short plan year return/report (less than 12 months)No
2015-07-01Plan is a collectively bargained planNo
2015-07-01Plan funding arrangement – InsuranceYes
2015-07-01Plan benefit arrangement – InsuranceYes
2014: HEALTH INSURANCE ACCIDENT & SICKNESS 2014 form 5500 responses
2014-07-01Type of plan entitySingle employer plan
2014-07-01Submission has been amendedNo
2014-07-01This submission is the final filingNo
2014-07-01This return/report is a short plan year return/report (less than 12 months)No
2014-07-01Plan is a collectively bargained planNo
2014-07-01Plan funding arrangement – InsuranceYes
2014-07-01Plan benefit arrangement – InsuranceYes
2013: HEALTH INSURANCE ACCIDENT & SICKNESS 2013 form 5500 responses
2013-07-01Type of plan entitySingle employer plan
2013-07-01Submission has been amendedNo
2013-07-01This submission is the final filingNo
2013-07-01This return/report is a short plan year return/report (less than 12 months)No
2013-07-01Plan is a collectively bargained planNo
2013-07-01Plan funding arrangement – InsuranceYes
2013-07-01Plan benefit arrangement – InsuranceYes
2012: HEALTH INSURANCE ACCIDENT & SICKNESS 2012 form 5500 responses
2012-07-01Type of plan entitySingle employer plan
2012-07-01Submission has been amendedYes
2012-07-01This submission is the final filingNo
2012-07-01This return/report is a short plan year return/report (less than 12 months)No
2012-07-01Plan is a collectively bargained planNo
2012-07-01Plan funding arrangement – InsuranceYes
2012-07-01Plan benefit arrangement – InsuranceYes
2011: HEALTH INSURANCE ACCIDENT & SICKNESS 2011 form 5500 responses
2011-07-01Type of plan entitySingle employer plan
2011-07-01First time form 5500 has been submittedYes
2011-07-01Submission has been amendedNo
2011-07-01This submission is the final filingNo
2011-07-01This return/report is a short plan year return/report (less than 12 months)No
2011-07-01Plan is a collectively bargained planNo
2011-07-01Plan funding arrangement – InsuranceYes
2011-07-01Plan benefit arrangement – InsuranceYes
2009: HEALTH INSURANCE ACCIDENT & SICKNESS 2009 form 5500 responses
2009-07-01Type of plan entitySingle employer plan
2009-07-01First time form 5500 has been submittedYes
2009-07-01Submission has been amendedYes
2009-07-01This submission is the final filingNo
2009-07-01This return/report is a short plan year return/report (less than 12 months)No
2009-07-01Plan is a collectively bargained planNo
2009-07-01Plan funding arrangement – InsuranceYes
2009-07-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

HUMANA (National Association of Insurance Commissioners NAIC id number: 95348 )
Policy contract number788550
Policy instance 3
HUMANA (National Association of Insurance Commissioners NAIC id number: 95348 )
Policy contract number788550
Policy instance 2
HUMANA (National Association of Insurance Commissioners NAIC id number: 95348 )
Policy contract number788550
Policy instance 1
HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 )
Policy contract number788550
Policy instance 3
HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 )
Policy contract number788550
Policy instance 2
HUMANA (National Association of Insurance Commissioners NAIC id number: 95348 )
Policy contract number788550
Policy instance 1
HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 )
Policy contract number788550
Policy instance 3
HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 )
Policy contract number788550
Policy instance 2
HUMANA (National Association of Insurance Commissioners NAIC id number: 95348 )
Policy contract number788550
Policy instance 1
HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 )
Policy contract number788550
Policy instance 3
HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 )
Policy contract number788550
Policy instance 2
HUMANA (National Association of Insurance Commissioners NAIC id number: 95348 )
Policy contract number788550
Policy instance 1

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