TOMAH MEMORIAL HOSPITAL has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan HEALTH BENEFITS FOR EMPLOYEES OF TOMAH MEMORIAL HOSPITAL
401k plan membership statisitcs for HEALTH BENEFITS FOR EMPLOYEES OF TOMAH MEMORIAL HOSPITAL
| Measure | Date | Value |
|---|
| 2022: HEALTH BENEFITS FOR EMPLOYEES OF TOMAH MEMORIAL HOSPITAL 2022 401k membership |
|---|
| Total participants, beginning-of-year | 2022-01-01 | 189 |
| Total number of active participants reported on line 7a of the Form 5500 | 2022-01-01 | 199 |
| Total of all active and inactive participants | 2022-01-01 | 199 |
| Total participants | 2022-01-01 | 199 |
| 2021: HEALTH BENEFITS FOR EMPLOYEES OF TOMAH MEMORIAL HOSPITAL 2021 401k membership |
|---|
| Total participants, beginning-of-year | 2021-01-01 | 193 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-01-01 | 189 |
| Total of all active and inactive participants | 2021-01-01 | 189 |
| Total participants | 2021-01-01 | 189 |
| 2020: HEALTH BENEFITS FOR EMPLOYEES OF TOMAH MEMORIAL HOSPITAL 2020 401k membership |
|---|
| Total participants, beginning-of-year | 2020-01-01 | 190 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-01-01 | 193 |
| Total of all active and inactive participants | 2020-01-01 | 193 |
| Total participants | 2020-01-01 | 193 |
| 2019: HEALTH BENEFITS FOR EMPLOYEES OF TOMAH MEMORIAL HOSPITAL 2019 401k membership |
|---|
| Total participants, beginning-of-year | 2019-01-01 | 184 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-01-01 | 190 |
| Total of all active and inactive participants | 2019-01-01 | 190 |
| Total participants | 2019-01-01 | 190 |
| 2018: HEALTH BENEFITS FOR EMPLOYEES OF TOMAH MEMORIAL HOSPITAL 2018 401k membership |
|---|
| Total participants, beginning-of-year | 2018-01-01 | 189 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-01-01 | 184 |
| Total of all active and inactive participants | 2018-01-01 | 184 |
| Total participants | 2018-01-01 | 184 |
| 2017: HEALTH BENEFITS FOR EMPLOYEES OF TOMAH MEMORIAL HOSPITAL 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-01-01 | 169 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-01-01 | 189 |
| Total of all active and inactive participants | 2017-01-01 | 189 |
| Total participants | 2017-01-01 | 189 |
| 2016: HEALTH BENEFITS FOR EMPLOYEES OF TOMAH MEMORIAL HOSPITAL 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-01-01 | 156 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-01-01 | 169 |
| Total of all active and inactive participants | 2016-01-01 | 169 |
| Total participants | 2016-01-01 | 169 |
| 2015: HEALTH BENEFITS FOR EMPLOYEES OF TOMAH MEMORIAL HOSPITAL 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-01-01 | 161 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-01-01 | 156 |
| Total of all active and inactive participants | 2015-01-01 | 156 |
| Total participants | 2015-01-01 | 156 |
| 2014: HEALTH BENEFITS FOR EMPLOYEES OF TOMAH MEMORIAL HOSPITAL 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-01-01 | 308 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-01-01 | 161 |
| Total of all active and inactive participants | 2014-01-01 | 161 |
| Total participants | 2014-01-01 | 161 |
| 2013: HEALTH BENEFITS FOR EMPLOYEES OF TOMAH MEMORIAL HOSPITAL 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-01-01 | 263 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-01-01 | 308 |
| Total of all active and inactive participants | 2013-01-01 | 308 |
| Total participants | 2013-01-01 | 308 |
| 2012: HEALTH BENEFITS FOR EMPLOYEES OF TOMAH MEMORIAL HOSPITAL 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-01-01 | 148 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-01-01 | 263 |
| Total of all active and inactive participants | 2012-01-01 | 263 |
| Total participants | 2012-01-01 | 263 |
| 2011: HEALTH BENEFITS FOR EMPLOYEES OF TOMAH MEMORIAL HOSPITAL 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-01-01 | 147 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-01-01 | 148 |
| Total of all active and inactive participants | 2011-01-01 | 148 |
| Total participants | 2011-01-01 | 148 |
| 2009: HEALTH BENEFITS FOR EMPLOYEES OF TOMAH MEMORIAL HOSPITAL 2009 401k membership |
|---|
| Total participants, beginning-of-year | 2009-01-01 | 149 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-01-01 | 147 |
| Total of all active and inactive participants | 2009-01-01 | 147 |
| Total participants | 2009-01-01 | 147 |
| 2022: HEALTH BENEFITS FOR EMPLOYEES OF TOMAH MEMORIAL HOSPITAL 2022 form 5500 responses |
|---|
| 2022-01-01 | Type of plan entity | Single employer plan |
| 2022-01-01 | Plan funding arrangement – Insurance | Yes |
| 2022-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2021: HEALTH BENEFITS FOR EMPLOYEES OF TOMAH MEMORIAL HOSPITAL 2021 form 5500 responses |
|---|
| 2021-01-01 | Type of plan entity | Single employer plan |
| 2021-01-01 | Plan funding arrangement – Insurance | Yes |
| 2021-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2020: HEALTH BENEFITS FOR EMPLOYEES OF TOMAH MEMORIAL HOSPITAL 2020 form 5500 responses |
|---|
| 2020-01-01 | Type of plan entity | Single employer plan |
| 2020-01-01 | Plan funding arrangement – Insurance | Yes |
| 2020-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2019: HEALTH BENEFITS FOR EMPLOYEES OF TOMAH MEMORIAL HOSPITAL 2019 form 5500 responses |
|---|
| 2019-01-01 | Type of plan entity | Single employer plan |
| 2019-01-01 | Plan funding arrangement – Insurance | Yes |
| 2019-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2018: HEALTH BENEFITS FOR EMPLOYEES OF TOMAH MEMORIAL HOSPITAL 2018 form 5500 responses |
|---|
| 2018-01-01 | Type of plan entity | Single employer plan |
| 2018-01-01 | Plan funding arrangement – Insurance | Yes |
| 2018-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2017: HEALTH BENEFITS FOR EMPLOYEES OF TOMAH MEMORIAL HOSPITAL 2017 form 5500 responses |
|---|
| 2017-01-01 | Type of plan entity | Single employer plan |
| 2017-01-01 | Plan funding arrangement – Insurance | Yes |
| 2017-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2016: HEALTH BENEFITS FOR EMPLOYEES OF TOMAH MEMORIAL HOSPITAL 2016 form 5500 responses |
|---|
| 2016-01-01 | Type of plan entity | Single employer plan |
| 2016-01-01 | Plan funding arrangement – Insurance | Yes |
| 2016-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2015: HEALTH BENEFITS FOR EMPLOYEES OF TOMAH MEMORIAL HOSPITAL 2015 form 5500 responses |
|---|
| 2015-01-01 | Type of plan entity | Single employer plan |
| 2015-01-01 | Plan funding arrangement – Insurance | Yes |
| 2015-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2014: HEALTH BENEFITS FOR EMPLOYEES OF TOMAH MEMORIAL HOSPITAL 2014 form 5500 responses |
|---|
| 2014-01-01 | Type of plan entity | Single employer plan |
| 2014-01-01 | Plan funding arrangement – Insurance | Yes |
| 2014-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2013: HEALTH BENEFITS FOR EMPLOYEES OF TOMAH MEMORIAL HOSPITAL 2013 form 5500 responses |
|---|
| 2013-01-01 | Type of plan entity | Single employer plan |
| 2013-01-01 | Plan funding arrangement – Insurance | Yes |
| 2013-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2012: HEALTH BENEFITS FOR EMPLOYEES OF TOMAH MEMORIAL HOSPITAL 2012 form 5500 responses |
|---|
| 2012-01-01 | Type of plan entity | Single employer plan |
| 2012-01-01 | Plan funding arrangement – Insurance | Yes |
| 2012-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2011: HEALTH BENEFITS FOR EMPLOYEES OF TOMAH MEMORIAL HOSPITAL 2011 form 5500 responses |
|---|
| 2011-01-01 | Type of plan entity | Single employer plan |
| 2011-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2011-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2009: HEALTH BENEFITS FOR EMPLOYEES OF TOMAH MEMORIAL HOSPITAL 2009 form 5500 responses |
|---|
| 2009-01-01 | Type of plan entity | Single employer plan |
| 2009-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2009-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
| Policy contract number | 8578 |
| Policy instance | 3 |
| Insurance contract or identification number | 8578 | | Number of Individuals Covered | 363 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $2,622 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $32,776 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,622 | | Insurance broker organization code? | 3 |
|
| COMPCARE HEALTH SERVICES INSURANCE CORPORATION (National Association of Insurance Commissioners NAIC id number: 95693 ) |
| Policy contract number | 00242088 |
| Policy instance | 2 |
| Insurance contract or identification number | 00242088 | | Number of Individuals Covered | 477 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $70,075 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $6,379,202 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $29,275 | | Insurance broker organization code? | 3 |
|
| DELTA DENTAL OF WISCONSIN (National Association of Insurance Commissioners NAIC id number: 54046 ) |
| Policy contract number | 3215 |
| Policy instance | 1 |
| Insurance contract or identification number | 3215 | | Number of Individuals Covered | 238 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $12,386 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $12,386 | | Insurance broker organization code? | 3 |
|
| NATIONAL GUARDIAN LIFE (National Association of Insurance Commissioners NAIC id number: 66583 ) |
| Policy contract number | 8578 |
| Policy instance | 3 |
| Insurance contract or identification number | 8578 | | Number of Individuals Covered | 395 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $2,844 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $35,556 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,844 | | Insurance broker organization code? | 3 |
|
| COMPCARE HEALTH SERVICES INSURANCE CORPORATION (National Association of Insurance Commissioners NAIC id number: 95693 ) |
| Policy contract number | 00242088 |
| Policy instance | 2 |
| Insurance contract or identification number | 00242088 | | Number of Individuals Covered | 450 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $66,725 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $5,713,484 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $66,725 | | Insurance broker organization code? | 3 |
|
| DELTA DENTAL OF WISCONSIN (National Association of Insurance Commissioners NAIC id number: 54046 ) |
| Policy contract number | 3215 |
| Policy instance | 1 |
| Insurance contract or identification number | 3215 | | Number of Individuals Covered | 226 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $12,303 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $12,303 | | Insurance broker organization code? | 3 |
|
| NATIONAL GUARDIAN LIFE (National Association of Insurance Commissioners NAIC id number: 66583 ) |
| Policy contract number | 8578 |
| Policy instance | 3 |
| Insurance contract or identification number | 8578 | | Number of Individuals Covered | 376 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $2,801 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $35,007 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,801 | | Insurance broker organization code? | 3 |
|
| COMPCARE HEALTH SERVICES INSURANCE CORPORATION (National Association of Insurance Commissioners NAIC id number: 95693 ) |
| Policy contract number | 00242088 |
| Policy instance | 2 |
| Insurance contract or identification number | 00242088 | | Number of Individuals Covered | 445 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $68,675 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $5,742,419 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $68,675 | | Insurance broker organization code? | 3 |
|
| DELTA DENTAL OF WISCONSIN (National Association of Insurance Commissioners NAIC id number: 54046 ) |
| Policy contract number | 3215 |
| Policy instance | 1 |
| Insurance contract or identification number | 3215 | | Number of Individuals Covered | 239 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $10,335 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $10,335 | | Insurance broker organization code? | 3 |
|
| NATIONAL GUARDIAN LIFE (National Association of Insurance Commissioners NAIC id number: 66583 ) |
| Policy contract number | 8578 |
| Policy instance | 3 |
| Insurance contract or identification number | 8578 | | Number of Individuals Covered | 370 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $2,678 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $33,470 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,678 |
|
| COMPCARE HEALTH SERVICES INSURANCE CORPORATION (National Association of Insurance Commissioners NAIC id number: 95693 ) |
| Policy contract number | 00242088 |
| Policy instance | 2 |
| Insurance contract or identification number | 00242088 | | Number of Individuals Covered | 441 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $61,300 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $5,354,056 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $61,300 | | Insurance broker organization code? | 3 |
|
| DELTA DENTAL OF WISCONSIN (National Association of Insurance Commissioners NAIC id number: 54046 ) |
| Policy contract number | 3215 |
| Policy instance | 1 |
| Insurance contract or identification number | 3215 | | Number of Individuals Covered | 223 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $11,185 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $11,185 | | Insurance broker organization code? | 3 |
|
| NATIONAL GUARDIAN LIFE (National Association of Insurance Commissioners NAIC id number: 66583 ) |
| Policy contract number | 8578 |
| Policy instance | 3 |
| Insurance contract or identification number | 8578 | | Number of Individuals Covered | 331 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $2,357 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $29,463 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $378 | | Insurance broker organization code? | 3 |
|
| COMPCARE HEALTH SERVICES INSURANCE CORPORATION (National Association of Insurance Commissioners NAIC id number: 95693 ) |
| Policy contract number | 00242088 |
| Policy instance | 2 |
| Insurance contract or identification number | 00242088 | | Number of Individuals Covered | 445 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $58,580 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $4,930,892 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $58,580 | | Insurance broker organization code? | 3 |
|
| DELTA DENTAL OF WISCONSIN (National Association of Insurance Commissioners NAIC id number: 54046 ) |
| Policy contract number | 3215 |
| Policy instance | 1 |
| Insurance contract or identification number | 3215 | | Number of Individuals Covered | 213 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $14,410 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $14,410 | | Insurance broker organization code? | 3 |
|
| NATIONAL GUARDIAN LIFE (National Association of Insurance Commissioners NAIC id number: 66583 ) |
| Policy contract number | 8578 |
| Policy instance | 3 |
| Insurance contract or identification number | 8578 | | Number of Individuals Covered | 288 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $2,201 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $27,508 | | Commission paid to Insurance Broker | USD $734 | | Insurance broker organization code? | 3 | | Insurance broker name | NATIONAL BENEFIT PARTNERS LLC |
|
| COMPCARE HEALTH SERVICES INSURANCE CORPORATION (National Association of Insurance Commissioners NAIC id number: 95693 ) |
| Policy contract number | 00242088 |
| Policy instance | 2 |
| Insurance contract or identification number | 00242088 | | Number of Individuals Covered | 189 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $53,375 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $3,931,886 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $53,375 | | Insurance broker name | LAMAIR MULOCK CONDON CO |
|
| DELTA DENTAL OF WISCONSIN (National Association of Insurance Commissioners NAIC id number: 54046 ) |
| Policy contract number | 3215 |
| Policy instance | 1 |
| Insurance contract or identification number | 3215 | | Number of Individuals Covered | 198 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $11,649 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $11,649 | | Insurance broker organization code? | 3 | | Insurance broker name | LAMAIR MULOCK CONDON CO |
|
