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BEAVER DAM COMMUNITY HOSPITALS INC EMPLOYEE HEALTH INSURANCE 401k Plan overview

Plan NameBEAVER DAM COMMUNITY HOSPITALS INC EMPLOYEE HEALTH INSURANCE
Plan identification number 503

BEAVER DAM COMMUNITY HOSPITALS INC EMPLOYEE HEALTH INSURANCE Benefits

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

401k Sponsoring company profile

BEAVER DAM COMMUNITY HOSPITALS, INC has sponsored the creation of one or more 401k plans.

Company Name:BEAVER DAM COMMUNITY HOSPITALS, INC
Employer identification number (EIN):391157876
NAIC Classification:622000
NAIC Description: Hospitals

Form 5500 Filing Information

Submission information for form 5500 for 401k plan BEAVER DAM COMMUNITY HOSPITALS INC EMPLOYEE HEALTH INSURANCE

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5032021-01-01
5032020-01-01
5032019-01-01
5032017-01-01MELANIE BRUINS
5032016-01-01MELANIE BRUINS
5032015-01-01MELANIE BRUINS
5032014-01-01MELANIE BRUINS
5032013-01-01MELANIE BRUINS
5032012-01-01BRIDGET SHERIDAN
5032011-01-01DONNA HUTCHINSON
5032010-01-01DONNA HUTCHINSON
5032009-01-01JONATHAN RING

Plan Statistics for BEAVER DAM COMMUNITY HOSPITALS INC EMPLOYEE HEALTH INSURANCE

401k plan membership statisitcs for BEAVER DAM COMMUNITY HOSPITALS INC EMPLOYEE HEALTH INSURANCE

Measure Date Value
2021: BEAVER DAM COMMUNITY HOSPITALS INC EMPLOYEE HEALTH INSURANCE 2021 401k membership
Total participants, beginning-of-year2021-01-01439
Total number of active participants reported on line 7a of the Form 55002021-01-010
Number of retired or separated participants receiving benefits2021-01-010
Number of other retired or separated participants entitled to future benefits2021-01-010
Total of all active and inactive participants2021-01-010
2020: BEAVER DAM COMMUNITY HOSPITALS INC EMPLOYEE HEALTH INSURANCE 2020 401k membership
Total participants, beginning-of-year2020-01-01461
Total number of active participants reported on line 7a of the Form 55002020-01-01439
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 participants2020-01-01439
2019: BEAVER DAM COMMUNITY HOSPITALS INC EMPLOYEE HEALTH INSURANCE 2019 401k membership
Total participants, beginning-of-year2019-01-01458
Total number of active participants reported on line 7a of the Form 55002019-01-01454
Number of retired or separated participants receiving benefits2019-01-017
Number of other retired or separated participants entitled to future benefits2019-01-010
Total of all active and inactive participants2019-01-01461
2017: BEAVER DAM COMMUNITY HOSPITALS INC EMPLOYEE HEALTH INSURANCE 2017 401k membership
Total participants, beginning-of-year2017-01-01483
Total number of active participants reported on line 7a of the Form 55002017-01-01464
Number of retired or separated participants receiving benefits2017-01-011
Number of other retired or separated participants entitled to future benefits2017-01-010
Total of all active and inactive participants2017-01-01465
2016: BEAVER DAM COMMUNITY HOSPITALS INC EMPLOYEE HEALTH INSURANCE 2016 401k membership
Total participants, beginning-of-year2016-01-01482
Total number of active participants reported on line 7a of the Form 55002016-01-01480
Number of retired or separated participants receiving benefits2016-01-010
Number of other retired or separated participants entitled to future benefits2016-01-010
Total of all active and inactive participants2016-01-01480
2015: BEAVER DAM COMMUNITY HOSPITALS INC EMPLOYEE HEALTH INSURANCE 2015 401k membership
Total participants, beginning-of-year2015-01-01519
Total number of active participants reported on line 7a of the Form 55002015-01-01475
Number of retired or separated participants receiving benefits2015-01-013
Number of other retired or separated participants entitled to future benefits2015-01-010
Total of all active and inactive participants2015-01-01478
2014: BEAVER DAM COMMUNITY HOSPITALS INC EMPLOYEE HEALTH INSURANCE 2014 401k membership
Total participants, beginning-of-year2014-01-01525
Total number of active participants reported on line 7a of the Form 55002014-01-01215
Number of retired or separated participants receiving benefits2014-01-013
Number of other retired or separated participants entitled to future benefits2014-01-010
Total of all active and inactive participants2014-01-01218
2013: BEAVER DAM COMMUNITY HOSPITALS INC EMPLOYEE HEALTH INSURANCE 2013 401k membership
Total participants, beginning-of-year2013-01-01551
Total number of active participants reported on line 7a of the Form 55002013-01-01525
Number of retired or separated participants receiving benefits2013-01-010
Number of other retired or separated participants entitled to future benefits2013-01-019
Total of all active and inactive participants2013-01-01534
2012: BEAVER DAM COMMUNITY HOSPITALS INC EMPLOYEE HEALTH INSURANCE 2012 401k membership
Total participants, beginning-of-year2012-01-01520
Total number of active participants reported on line 7a of the Form 55002012-01-01528
Total of all active and inactive participants2012-01-01528
Total participants2012-01-01528
2011: BEAVER DAM COMMUNITY HOSPITALS INC EMPLOYEE HEALTH INSURANCE 2011 401k membership
Total participants, beginning-of-year2011-01-01554
Total number of active participants reported on line 7a of the Form 55002011-01-01520
Total of all active and inactive participants2011-01-01520
Total participants2011-01-01520
2010: BEAVER DAM COMMUNITY HOSPITALS INC EMPLOYEE HEALTH INSURANCE 2010 401k membership
Total participants, beginning-of-year2010-01-01533
Total number of active participants reported on line 7a of the Form 55002010-01-01554
Total of all active and inactive participants2010-01-01554
Total participants2010-01-01554
2009: BEAVER DAM COMMUNITY HOSPITALS INC EMPLOYEE HEALTH INSURANCE 2009 401k membership
Total participants, beginning-of-year2009-01-01505
Total number of active participants reported on line 7a of the Form 55002009-01-01533
Total of all active and inactive participants2009-01-01533
Total participants2009-01-01533

Form 5500 Responses for BEAVER DAM COMMUNITY HOSPITALS INC EMPLOYEE HEALTH INSURANCE

2021: BEAVER DAM COMMUNITY HOSPITALS INC EMPLOYEE HEALTH INSURANCE 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Submission has been amendedNo
2021-01-01This submission is the final filingYes
2021-01-01This return/report is a short plan year return/report (less than 12 months)Yes
2021-01-01Plan is a collectively bargained planNo
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan benefit arrangement – InsuranceYes
2020: BEAVER DAM COMMUNITY HOSPITALS INC EMPLOYEE HEALTH INSURANCE 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Submission has been amendedNo
2020-01-01This submission is the final filingNo
2020-01-01This return/report is a short plan year return/report (less than 12 months)No
2020-01-01Plan is a collectively bargained planNo
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan benefit arrangement – InsuranceYes
2019: BEAVER DAM COMMUNITY HOSPITALS INC EMPLOYEE HEALTH INSURANCE 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Submission has been amendedNo
2019-01-01This submission is the final filingNo
2019-01-01This return/report is a short plan year return/report (less than 12 months)No
2019-01-01Plan is a collectively bargained planNo
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan benefit arrangement – InsuranceYes
2017: BEAVER DAM COMMUNITY HOSPITALS INC EMPLOYEE HEALTH INSURANCE 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Submission has been amendedNo
2017-01-01This submission is the final filingNo
2017-01-01This return/report is a short plan year return/report (less than 12 months)No
2017-01-01Plan is a collectively bargained planNo
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan benefit arrangement – InsuranceYes
2016: BEAVER DAM COMMUNITY HOSPITALS INC EMPLOYEE HEALTH INSURANCE 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Submission has been amendedNo
2016-01-01This submission is the final filingNo
2016-01-01This return/report is a short plan year return/report (less than 12 months)No
2016-01-01Plan is a collectively bargained planNo
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan benefit arrangement – InsuranceYes
2015: BEAVER DAM COMMUNITY HOSPITALS INC EMPLOYEE HEALTH INSURANCE 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Submission has been amendedNo
2015-01-01This submission is the final filingNo
2015-01-01This return/report is a short plan year return/report (less than 12 months)No
2015-01-01Plan is a collectively bargained planNo
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan benefit arrangement – InsuranceYes
2014: BEAVER DAM COMMUNITY HOSPITALS INC EMPLOYEE HEALTH INSURANCE 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Submission has been amendedNo
2014-01-01This submission is the final filingNo
2014-01-01This return/report is a short plan year return/report (less than 12 months)No
2014-01-01Plan is a collectively bargained planNo
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan benefit arrangement – InsuranceYes
2013: BEAVER DAM COMMUNITY HOSPITALS INC EMPLOYEE HEALTH INSURANCE 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Submission has been amendedNo
2013-01-01This submission is the final filingNo
2013-01-01This return/report is a short plan year return/report (less than 12 months)No
2013-01-01Plan is a collectively bargained planNo
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan benefit arrangement – InsuranceYes
2012: BEAVER DAM COMMUNITY HOSPITALS INC EMPLOYEE HEALTH INSURANCE 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Submission has been amendedNo
2012-01-01This submission is the final filingNo
2012-01-01This return/report is a short plan year return/report (less than 12 months)No
2012-01-01Plan is a collectively bargained planNo
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan benefit arrangement – InsuranceYes
2011: BEAVER DAM COMMUNITY HOSPITALS INC EMPLOYEE HEALTH INSURANCE 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Submission has been amendedNo
2011-01-01This submission is the final filingNo
2011-01-01This return/report is a short plan year return/report (less than 12 months)No
2011-01-01Plan is a collectively bargained planNo
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan benefit arrangement – InsuranceYes
2010: BEAVER DAM COMMUNITY HOSPITALS INC EMPLOYEE HEALTH INSURANCE 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01Submission has been amendedNo
2010-01-01This submission is the final filingNo
2010-01-01This return/report is a short plan year return/report (less than 12 months)No
2010-01-01Plan is a collectively bargained planNo
2010-01-01Plan funding arrangement – InsuranceYes
2010-01-01Plan benefit arrangement – InsuranceYes
2009: BEAVER DAM COMMUNITY HOSPITALS INC EMPLOYEE HEALTH INSURANCE 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Submission has been amendedNo
2009-01-01This submission is the final filingNo
2009-01-01This return/report is a short plan year return/report (less than 12 months)No
2009-01-01Plan is a collectively bargained planNo
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number10068121001
Policy instance 1
DELTA DENTAL OF WISCONSIN (National Association of Insurance Commissioners NAIC id number: 54046 )
Policy contract number06116 0000
Policy instance 3
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number10068121001
Policy instance 2
DELTA DENTAL OF WISCONSIN (National Association of Insurance Commissioners NAIC id number: 54046 )
Policy contract number00606 00000
Policy instance 1
DELTA DENTAL OF WISCONSIN (National Association of Insurance Commissioners NAIC id number: 54046 )
Policy contract number06116 0000
Policy instance 3
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number10068121001
Policy instance 2
DELTA DENTAL OF WISCONSIN (National Association of Insurance Commissioners NAIC id number: 54046 )
Policy contract number00606 00000
Policy instance 1
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number10068121001
Policy instance 2
DELTA DENTAL OF WISCONSIN (National Association of Insurance Commissioners NAIC id number: 54046 )
Policy contract number06116 0000
Policy instance 3
DELTA DENTAL OF WISCONSIN (National Association of Insurance Commissioners NAIC id number: 54046 )
Policy contract number00606 00000
Policy instance 1
DELTA DENTAL OF WISCONSIN (National Association of Insurance Commissioners NAIC id number: 54046 )
Policy contract number00606 00000
Policy instance 1
WYSSTA INSURANCE COMPANY INC. (National Association of Insurance Commissioners NAIC id number: 12352 )
Policy contract number40102 00000
Policy instance 2
WYSSTA INSURANCE COMPANY INC. (National Association of Insurance Commissioners NAIC id number: 12352 )
Policy contract number40829 00000
Policy instance 3
WYSSTA INSURANCE COMPANY INC. (National Association of Insurance Commissioners NAIC id number: 12352 )
Policy contract number40102 00000
Policy instance 2
DELTA DENTAL OF WISCONSIN (National Association of Insurance Commissioners NAIC id number: 54046 )
Policy contract number00606 00000
Policy instance 1
WYSSTA INSURANCE COMPANY INC. (National Association of Insurance Commissioners NAIC id number: 12352 )
Policy contract number40829 00000
Policy instance 3
DELTA DENTAL OF WISCONSIN (National Association of Insurance Commissioners NAIC id number: 54046 )
Policy contract number00606 00000
Policy instance 1
WYSSTA INSURANCE COMPANY INC. (National Association of Insurance Commissioners NAIC id number: 12352 )
Policy contract number40102 00000
Policy instance 2
DELTA DENTAL OF WISCONSIN (National Association of Insurance Commissioners NAIC id number: 54046 )
Policy contract number00606 00000
Policy instance 3
WISCONSIN PHYSICIANS SERVICE INSURANCE CORPORATION (National Association of Insurance Commissioners NAIC id number: 53139 )
Policy contract number174430
Policy instance 2
WISCONSIN PHYSICIANS SERVICE INSURANCE CORPORATION (National Association of Insurance Commissioners NAIC id number: 53139 )
Policy contract number174430
Policy instance 1
WYSSTA INSURANCE COMPANY INC. (National Association of Insurance Commissioners NAIC id number: 12352 )
Policy contract number40102 00000
Policy instance 4
DELTA DENTAL OF WISCONSIN (National Association of Insurance Commissioners NAIC id number: 54046 )
Policy contract number00606 00000
Policy instance 5
WYSSTA INSURANCE COMPANY INC. (National Association of Insurance Commissioners NAIC id number: 12352 )
Policy contract number40102 00000
Policy instance 4
WISCONSIN PHYSICIANS SERVICE INSURANCE CORPORATION (National Association of Insurance Commissioners NAIC id number: 53139 )
Policy contract number174430
Policy instance 3
DEAN HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 96156 )
Policy contract number32370-32375P
Policy instance 2
UNITY HEALTH PLANS INSURANCE CORPORATION (National Association of Insurance Commissioners NAIC id number: 95796 )
Policy contract number30311
Policy instance 1
DELTA DENTAL OF WISCONSIN (National Association of Insurance Commissioners NAIC id number: 54046 )
Policy contract number00606 00000
Policy instance 1
WYSSTA INSURANCE COMPANY INC. (National Association of Insurance Commissioners NAIC id number: 12352 )
Policy contract number40102 00000
Policy instance 2
DEAN HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 96156 )
Policy contract number32370-32375P
Policy instance 3
UNITY HEALTH PLANS INSURANCE CORPORATION (National Association of Insurance Commissioners NAIC id number: 95796 )
Policy contract number30311
Policy instance 4

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