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GROUP SHORT TERM DISABILITY INSURANCE FOR EMPLOYEES OF BURNETT MEDICAL CENTER 401k Plan overview

Plan NameGROUP SHORT TERM DISABILITY INSURANCE FOR EMPLOYEES OF BURNETT MEDICAL CENTER
Plan identification number 505

GROUP SHORT TERM DISABILITY INSURANCE FOR EMPLOYEES OF BURNETT MEDICAL CENTER Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Temporary disability (accident and sickness)

401k Sponsoring company profile

BURNETT MEDICAL CENTER has sponsored the creation of one or more 401k plans.

Company Name:BURNETT MEDICAL CENTER
Employer identification number (EIN):390938661
NAIC Classification:622000
NAIC Description: Hospitals

Form 5500 Filing Information

Submission information for form 5500 for 401k plan GROUP SHORT TERM DISABILITY INSURANCE FOR EMPLOYEES OF BURNETT MEDICAL CENTER

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5052023-01-01JULIE MCKENZIE2024-07-25 JULIE MCKENZIE2024-07-25
5052022-01-01JULIE MCKENZIE2023-07-18 JULIE MCKENZIE2023-07-18
5052021-01-01JULIE MCKENZIE2022-07-15 JULIE MCKENZIE2022-07-15
5052020-01-01JULIE MCKENZIE2021-07-22 JULIE MCKENZIE2021-07-22
5052019-01-01SANDRA HINRICHS2020-07-02 SANDRA HINRICHS2020-07-02
5052018-01-01GORDON A LEWIS2019-07-31 GORDON A LEWIS2019-07-31
5052017-01-01
5052016-01-01
5052015-01-01
5052014-01-01
5052013-01-01
5052012-01-01SANDRA HINNICHS
5052011-01-01SANDRA HINRICHS
5052010-01-01SANDY HINRICHS
5052009-01-01SANDRA HINNCHS

Form 5500 Responses for GROUP SHORT TERM DISABILITY INSURANCE FOR EMPLOYEES OF BURNETT MEDICAL CENTER

2023: GROUP SHORT TERM DISABILITY INSURANCE FOR EMPLOYEES OF BURNETT MEDICAL CENTER 2023 form 5500 responses
2023-01-01Type of plan entitySingle employer plan
2023-01-01Plan funding arrangement – InsuranceYes
2023-01-01Plan benefit arrangement – InsuranceYes
2022: GROUP SHORT TERM DISABILITY INSURANCE FOR EMPLOYEES OF BURNETT MEDICAL CENTER 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan benefit arrangement – InsuranceYes
2021: GROUP SHORT TERM DISABILITY INSURANCE FOR EMPLOYEES OF BURNETT MEDICAL CENTER 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan benefit arrangement – InsuranceYes
2020: GROUP SHORT TERM DISABILITY INSURANCE FOR EMPLOYEES OF BURNETT MEDICAL CENTER 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: GROUP SHORT TERM DISABILITY INSURANCE FOR EMPLOYEES OF BURNETT MEDICAL CENTER 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: GROUP SHORT TERM DISABILITY INSURANCE FOR EMPLOYEES OF BURNETT MEDICAL CENTER 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan benefit arrangement – InsuranceYes
2017: GROUP SHORT TERM DISABILITY INSURANCE FOR EMPLOYEES OF BURNETT MEDICAL CENTER 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan benefit arrangement – InsuranceYes
2016: GROUP SHORT TERM DISABILITY INSURANCE FOR EMPLOYEES OF BURNETT MEDICAL CENTER 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan benefit arrangement – InsuranceYes
2015: GROUP SHORT TERM DISABILITY INSURANCE FOR EMPLOYEES OF BURNETT MEDICAL CENTER 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan benefit arrangement – InsuranceYes
2014: GROUP SHORT TERM DISABILITY INSURANCE FOR EMPLOYEES OF BURNETT MEDICAL CENTER 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan benefit arrangement – InsuranceYes
2013: GROUP SHORT TERM DISABILITY INSURANCE FOR EMPLOYEES OF BURNETT MEDICAL CENTER 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan benefit arrangement – InsuranceYes
2012: GROUP SHORT TERM DISABILITY INSURANCE FOR EMPLOYEES OF BURNETT MEDICAL CENTER 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan benefit arrangement – InsuranceYes
2011: GROUP SHORT TERM DISABILITY INSURANCE FOR EMPLOYEES OF BURNETT MEDICAL CENTER 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan benefit arrangement – InsuranceYes
2010: GROUP SHORT TERM DISABILITY INSURANCE FOR EMPLOYEES OF BURNETT MEDICAL CENTER 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01Plan funding arrangement – InsuranceYes
2010-01-01Plan benefit arrangement – InsuranceYes
2009: GROUP SHORT TERM DISABILITY INSURANCE FOR EMPLOYEES OF BURNETT MEDICAL CENTER 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberG 656342
Policy instance 1
Insurance contract or identification numberG 656342
Number of Individuals Covered154
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $26,171
Total amount of fees paid to insurance companyUSD $1,711
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $100,640
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberG 656342
Policy instance 1
Insurance contract or identification numberG 656342
Number of Individuals Covered153
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $24,826
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $114,127
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberG 656342
Policy instance 1
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberG 656342
Policy instance 1
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberG 656342
Policy instance 1
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberG 656342
Policy instance 1
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberG 656342
Policy instance 1
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberG 656342
Policy instance 1
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberG 656342
Policy instance 1
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberG 656342
Policy instance 1
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberG 656342
Policy instance 1
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberG 656342
Policy instance 1
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberG 656342
Policy instance 2
SUN LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80926 )
Policy contract number048-7796-00
Policy instance 1

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