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LONG TERM DISABILITY 401k Plan overview

Plan NameLONG TERM DISABILITY
Plan identification number 502

LONG TERM DISABILITY Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Long-term disability cover

401k Sponsoring company profile

GROVE CITY HEALTH SYSTEM has sponsored the creation of one or more 401k plans.

Company Name:GROVE CITY HEALTH SYSTEM
Employer identification number (EIN):320070801
NAIC Classification:622000
NAIC Description: Hospitals

Form 5500 Filing Information

Submission information for form 5500 for 401k plan LONG TERM DISABILITY

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5022020-01-01KIMBERLY J. CARBAUGH2021-09-13
5022019-01-01JAMES KANUCH2020-10-13
5022018-04-01

Plan Statistics for LONG TERM DISABILITY

401k plan membership statisitcs for LONG TERM DISABILITY

Measure Date Value
2020: LONG TERM DISABILITY 2020 401k membership
Total participants, beginning-of-year2020-01-01287
Total number of active participants reported on line 7a of the Form 55002020-01-01259
Number of retired or separated participants receiving benefits2020-01-010
Number of other retired or separated participants entitled to future benefits2020-01-010
Total of all active and inactive participants2020-01-01259
Number of employers contributing to the scheme2020-01-010
2019: LONG TERM DISABILITY 2019 401k membership
Total participants, beginning-of-year2019-01-01279
Total number of active participants reported on line 7a of the Form 55002019-01-01261
Number of retired or separated participants receiving benefits2019-01-010
Number of other retired or separated participants entitled to future benefits2019-01-010
Total of all active and inactive participants2019-01-01261
Number of employers contributing to the scheme2019-01-010
2018: LONG TERM DISABILITY 2018 401k membership
Total participants, beginning-of-year2018-04-01292
Total number of active participants reported on line 7a of the Form 55002018-04-01282
Number of retired or separated participants receiving benefits2018-04-012
Number of other retired or separated participants entitled to future benefits2018-04-010
Total of all active and inactive participants2018-04-01284
Number of employers contributing to the scheme2018-04-010

Form 5500 Responses for LONG TERM DISABILITY

2020: LONG TERM DISABILITY 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan benefit arrangement – InsuranceYes
2019: LONG TERM DISABILITY 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan benefit arrangement – InsuranceYes
2018: LONG TERM DISABILITY 2018 form 5500 responses
2018-04-01Type of plan entitySingle employer plan
2018-04-01First time form 5500 has been submittedYes
2018-04-01This return/report is a short plan year return/report (less than 12 months)Yes
2018-04-01Plan funding arrangement – InsuranceYes
2018-04-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberLTD129708
Policy instance 1
Insurance contract or identification numberLTD129708
Number of Individuals Covered259
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $5,964
Total amount of fees paid to insurance companyUSD $1,312
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $42,597
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,964
Amount paid for insurance broker fees1312
Additional information about fees paid to insurance brokerADMINISTRATIVE AND OTHER FEES
Insurance broker organization code?3
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberLTD129708
Policy instance 1
Insurance contract or identification numberLTD129708
Number of Individuals Covered282
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $6,124
Total amount of fees paid to insurance companyUSD $1,000
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $43,740
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,124
Amount paid for insurance broker fees1000
Additional information about fees paid to insurance brokerADMINISTRATIVE AND OTHER FEES
Insurance broker organization code?3
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberLTD129708
Policy instance 1
Insurance contract or identification numberLTD129708
Number of Individuals Covered291
Insurance policy start date2018-04-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $4,668
Total amount of fees paid to insurance companyUSD $0
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $33,341
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,668
Amount paid for insurance broker fees0
Insurance broker organization code?3

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