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LONG TERM DISABILITY BENEFITS FOR EMPLOYEES OF HAYWARD AREA MEMORIAL HOSPITAL 401k Plan overview

Plan NameLONG TERM DISABILITY BENEFITS FOR EMPLOYEES OF HAYWARD AREA MEMORIAL HOSPITAL
Plan identification number 510

LONG TERM DISABILITY BENEFITS FOR EMPLOYEES OF HAYWARD AREA MEMORIAL HOSPITAL Benefits

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

401k Sponsoring company profile

MEDICAL SERVICES, INC. DBA HAYWARD AREA MEMORIAL HOSPITAL has sponsored the creation of one or more 401k plans.

Company Name:MEDICAL SERVICES, INC. DBA HAYWARD AREA MEMORIAL HOSPITAL
Employer identification number (EIN):391536207
NAIC Classification:622000
NAIC Description: Hospitals

Form 5500 Filing Information

Submission information for form 5500 for 401k plan LONG TERM DISABILITY BENEFITS FOR EMPLOYEES OF HAYWARD AREA MEMORIAL HOSPITAL

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5102011-08-01TIM GULLINGSRUD
5102010-08-01TIM GULLINGSRUD
5102009-08-01BRAD ZELLER

Plan Statistics for LONG TERM DISABILITY BENEFITS FOR EMPLOYEES OF HAYWARD AREA MEMORIAL HOSPITAL

401k plan membership statisitcs for LONG TERM DISABILITY BENEFITS FOR EMPLOYEES OF HAYWARD AREA MEMORIAL HOSPITAL

Measure Date Value
2011: LONG TERM DISABILITY BENEFITS FOR EMPLOYEES OF HAYWARD AREA MEMORIAL HOSPITAL 2011 401k membership
Total participants, beginning-of-year2011-08-01220
Total number of active participants reported on line 7a of the Form 55002011-08-010
Number of retired or separated participants receiving benefits2011-08-010
Number of other retired or separated participants entitled to future benefits2011-08-010
Total of all active and inactive participants2011-08-010
2010: LONG TERM DISABILITY BENEFITS FOR EMPLOYEES OF HAYWARD AREA MEMORIAL HOSPITAL 2010 401k membership
Total participants, beginning-of-year2010-08-01223
Total number of active participants reported on line 7a of the Form 55002010-08-01220
Total of all active and inactive participants2010-08-01220
Total participants2010-08-01220
2009: LONG TERM DISABILITY BENEFITS FOR EMPLOYEES OF HAYWARD AREA MEMORIAL HOSPITAL 2009 401k membership
Total participants, beginning-of-year2009-08-010
Total number of active participants reported on line 7a of the Form 55002009-08-01223
Total of all active and inactive participants2009-08-01223
Total participants2009-08-01223

Form 5500 Responses for LONG TERM DISABILITY BENEFITS FOR EMPLOYEES OF HAYWARD AREA MEMORIAL HOSPITAL

2011: LONG TERM DISABILITY BENEFITS FOR EMPLOYEES OF HAYWARD AREA MEMORIAL HOSPITAL 2011 form 5500 responses
2011-08-01Type of plan entitySingle employer plan
2011-08-01Submission has been amendedYes
2011-08-01This submission is the final filingYes
2011-08-01This return/report is a short plan year return/report (less than 12 months)No
2011-08-01Plan is a collectively bargained planNo
2011-08-01Plan funding arrangement – InsuranceYes
2011-08-01Plan benefit arrangement – InsuranceYes
2010: LONG TERM DISABILITY BENEFITS FOR EMPLOYEES OF HAYWARD AREA MEMORIAL HOSPITAL 2010 form 5500 responses
2010-08-01Type of plan entitySingle employer plan
2010-08-01Plan funding arrangement – InsuranceYes
2010-08-01Plan benefit arrangement – InsuranceYes
2009: LONG TERM DISABILITY BENEFITS FOR EMPLOYEES OF HAYWARD AREA MEMORIAL HOSPITAL 2009 form 5500 responses
2009-08-01Type of plan entitySingle employer plan
2009-08-01First time form 5500 has been submittedYes
2009-08-01Plan funding arrangement – InsuranceYes
2009-08-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number220293
Policy instance 1
Insurance contract or identification number220293
Number of Individuals Covered225
Insurance policy start date2011-08-01
Insurance policy end date2012-07-31
Total amount of commissions paid to insurance brokerUSD $6,004
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $40,026
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,004
Insurance broker organization code?3
Insurance broker nameISG ADVISORS, LLC
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract numberH65729
Policy instance 1
Insurance contract or identification numberH65729
Number of Individuals Covered220
Insurance policy start date2010-08-01
Insurance policy end date2011-07-31
Total amount of commissions paid to insurance brokerUSD $6,828
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $45,519
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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