| Plan Name | GROUP DENTAL PLAN |
| Plan identification number | 504 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
|
| Company Name: | ELMHURST MEMORIAL HOSPITAL |
| Employer identification number (EIN): | 362167784 |
| NAIC Classification: | 622000 |
| NAIC Description: | Hospitals |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 504 | 2011-01-01 | LOIS GRUBB | LOIS GRUBB | 2012-10-11 | |
| 504 | 2009-01-01 | LOIS GRUBB | LOIS GRUBB | 2010-07-31 |
| Measure | Date | Value |
|---|---|---|
| 2011: GROUP DENTAL PLAN 2011 401k membership | ||
| Total participants, beginning-of-year | 2011-01-01 | 1,749 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-01-01 | 1,966 |
| Total of all active and inactive participants | 2011-01-01 | 1,966 |
| 2009: GROUP DENTAL PLAN 2009 401k membership | ||
| Total participants, beginning-of-year | 2009-01-01 | 1,829 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-01-01 | 1,864 |
| Total of all active and inactive participants | 2009-01-01 | 1,864 |
| 2011: GROUP DENTAL PLAN 2011 form 5500 responses | ||
|---|---|---|
| 2011-01-01 | Type of plan entity | Single employer plan |
| 2011-01-01 | Submission has been amended | Yes |
| 2011-01-01 | This submission is the final filing | Yes |
| 2011-01-01 | Plan funding arrangement – Insurance | Yes |
| 2011-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2009: GROUP DENTAL PLAN 2009 form 5500 responses | ||
| 2009-01-01 | Type of plan entity | Single employer plan |
| 2009-01-01 | This submission is the final filing | No |
| 2009-01-01 | Plan funding arrangement – Insurance | Yes |
| 2009-01-01 | Plan benefit arrangement – Insurance | Yes |