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LAKEVIEW MEMORIAL HOSPITAL GROUP DISABILITY INSURA 401k Plan overview

Plan NameLAKEVIEW MEMORIAL HOSPITAL GROUP DISABILITY INSURA
Plan identification number 502

LAKEVIEW MEMORIAL HOSPITAL GROUP DISABILITY INSURA Benefits

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

401k Sponsoring company profile

LAKEVIEW MEMORIAL HOSPITAL ASSOCIATION, INC. has sponsored the creation of one or more 401k plans.

Company Name:LAKEVIEW MEMORIAL HOSPITAL ASSOCIATION, INC.
Employer identification number (EIN):410811697
NAIC Classification:622000
NAIC Description: Hospitals

Form 5500 Filing Information

Submission information for form 5500 for 401k plan LAKEVIEW MEMORIAL HOSPITAL GROUP DISABILITY INSURA

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5022018-01-01DOUG JOHNSON DOUG JOHNSON2019-06-29
5022017-01-01DOUG JOHNSON2018-10-11 DOUG JOHNSON2018-10-11
5022016-01-01DOUG JOHNSON2017-07-17 DOUG JOHNSON2017-07-17
5022015-01-01DOUG JOHNSON2016-10-14 DOUG JOHNSON2016-10-14
5022014-01-01DOUG JOHNSON2015-10-13 DOUG JOHNSON2015-10-13
5022013-10-01DOUG JOHNSON2014-07-24 DOUG JOHNSON2014-07-24
5022012-10-01DOUG JOHNSON2013-12-15 DOUG JOHNSON2013-12-15
5022011-10-01DOUG JOHNSON2013-10-07 DOUG JOHNSON2013-10-07
5022010-07-01DOUGLAS JOHNSON
5022009-07-01DOUGLAS JOHNSON

Plan Statistics for LAKEVIEW MEMORIAL HOSPITAL GROUP DISABILITY INSURA

401k plan membership statisitcs for LAKEVIEW MEMORIAL HOSPITAL GROUP DISABILITY INSURA

Measure Date Value
2018: LAKEVIEW MEMORIAL HOSPITAL GROUP DISABILITY INSURA 2018 401k membership
Total participants, beginning-of-year2018-01-01407
Total number of active participants reported on line 7a of the Form 55002018-01-01403
Total of all active and inactive participants2018-01-01403
2017: LAKEVIEW MEMORIAL HOSPITAL GROUP DISABILITY INSURA 2017 401k membership
Total participants, beginning-of-year2017-01-01650
Total number of active participants reported on line 7a of the Form 55002017-01-01407
Total of all active and inactive participants2017-01-01407
2016: LAKEVIEW MEMORIAL HOSPITAL GROUP DISABILITY INSURA 2016 401k membership
Total participants, beginning-of-year2016-01-01616
Total number of active participants reported on line 7a of the Form 55002016-01-01650
Number of retired or separated participants receiving benefits2016-01-010
Total of all active and inactive participants2016-01-01650
2015: LAKEVIEW MEMORIAL HOSPITAL GROUP DISABILITY INSURA 2015 401k membership
Total participants, beginning-of-year2015-01-01733
Total number of active participants reported on line 7a of the Form 55002015-01-01616
Number of retired or separated participants receiving benefits2015-01-010
Total of all active and inactive participants2015-01-01616
2014: LAKEVIEW MEMORIAL HOSPITAL GROUP DISABILITY INSURA 2014 401k membership
Total participants, beginning-of-year2014-01-01752
Total number of active participants reported on line 7a of the Form 55002014-01-01733
Total of all active and inactive participants2014-01-01733
2013: LAKEVIEW MEMORIAL HOSPITAL GROUP DISABILITY INSURA 2013 401k membership
Total participants, beginning-of-year2013-10-01699
Total number of active participants reported on line 7a of the Form 55002013-10-01711
Total of all active and inactive participants2013-10-01711
2012: LAKEVIEW MEMORIAL HOSPITAL GROUP DISABILITY INSURA 2012 401k membership
Total participants, beginning-of-year2012-10-01706
Total number of active participants reported on line 7a of the Form 55002012-10-01699
Total of all active and inactive participants2012-10-01699
2011: LAKEVIEW MEMORIAL HOSPITAL GROUP DISABILITY INSURA 2011 401k membership
Total participants, beginning-of-year2011-10-01678
Total number of active participants reported on line 7a of the Form 55002011-10-01706
Number of retired or separated participants receiving benefits2011-10-010
Total of all active and inactive participants2011-10-01706
2010: LAKEVIEW MEMORIAL HOSPITAL GROUP DISABILITY INSURA 2010 401k membership
Total participants, beginning-of-year2010-07-01370
Total number of active participants reported on line 7a of the Form 55002010-07-01370
Total of all active and inactive participants2010-07-01370
Total participants2010-07-010
2009: LAKEVIEW MEMORIAL HOSPITAL GROUP DISABILITY INSURA 2009 401k membership
Total participants, beginning-of-year2009-07-01396
Total number of active participants reported on line 7a of the Form 55002009-07-01370
Total of all active and inactive participants2009-07-01370
Total participants2009-07-010

Form 5500 Responses for LAKEVIEW MEMORIAL HOSPITAL GROUP DISABILITY INSURA

2018: LAKEVIEW MEMORIAL HOSPITAL GROUP DISABILITY INSURA 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01This submission is the final filingYes
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan benefit arrangement – InsuranceYes
2017: LAKEVIEW MEMORIAL HOSPITAL GROUP DISABILITY INSURA 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: LAKEVIEW MEMORIAL HOSPITAL GROUP DISABILITY INSURA 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: LAKEVIEW MEMORIAL HOSPITAL GROUP DISABILITY INSURA 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: LAKEVIEW MEMORIAL HOSPITAL GROUP DISABILITY INSURA 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: LAKEVIEW MEMORIAL HOSPITAL GROUP DISABILITY INSURA 2013 form 5500 responses
2013-10-01Type of plan entitySingle employer plan
2013-10-01This return/report is a short plan year return/report (less than 12 months)Yes
2013-10-01Plan funding arrangement – InsuranceYes
2013-10-01Plan benefit arrangement – InsuranceYes
2012: LAKEVIEW MEMORIAL HOSPITAL GROUP DISABILITY INSURA 2012 form 5500 responses
2012-10-01Type of plan entitySingle employer plan
2012-10-01Plan funding arrangement – InsuranceYes
2012-10-01Plan benefit arrangement – InsuranceYes
2011: LAKEVIEW MEMORIAL HOSPITAL GROUP DISABILITY INSURA 2011 form 5500 responses
2011-10-01Type of plan entitySingle employer plan
2011-10-01Plan funding arrangement – InsuranceYes
2011-10-01Plan benefit arrangement – InsuranceYes
2010: LAKEVIEW MEMORIAL HOSPITAL GROUP DISABILITY INSURA 2010 form 5500 responses
2010-07-01Type of plan entitySingle employer plan
2010-07-01Submission has been amendedNo
2010-07-01This submission is the final filingNo
2010-07-01This return/report is a short plan year return/report (less than 12 months)Yes
2010-07-01Plan is a collectively bargained planNo
2010-07-01Plan funding arrangement – InsuranceYes
2010-07-01Plan funding arrangement – General assets of the sponsorYes
2010-07-01Plan benefit arrangement – InsuranceYes
2010-07-01Plan benefit arrangement – General assets of the sponsorYes
2009: LAKEVIEW MEMORIAL HOSPITAL GROUP DISABILITY INSURA 2009 form 5500 responses
2009-07-01Type of plan entitySingle employer plan
2009-07-01Submission has been amendedNo
2009-07-01This submission is the final filingNo
2009-07-01This return/report is a short plan year return/report (less than 12 months)No
2009-07-01Plan is a collectively bargained planNo
2009-07-01Plan funding arrangement – InsuranceYes
2009-07-01Plan funding arrangement – General assets of the sponsorYes
2009-07-01Plan benefit arrangement – InsuranceYes
2009-07-01Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberLK 962995
Policy instance 1
Insurance contract or identification numberLK 962995
Number of Individuals Covered403
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $11,162
Total amount of fees paid to insurance companyUSD $2,385
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $148,826
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $11,162
Amount paid for insurance broker fees2385
Additional information about fees paid to insurance brokerSALES AND SERVICE
Insurance broker organization code?3
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberLK 962995
Policy instance 1
Insurance contract or identification numberLK 962995
Number of Individuals Covered662
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $14,294
Total amount of fees paid to insurance companyUSD $3,180
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $190,593
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $14,294
Amount paid for insurance broker fees3180
Insurance broker organization code?3
Insurance broker nameGALLAGHER BENEFIT SERVICE
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberLK 962995
Policy instance 1
Insurance contract or identification numberLK 962995
Number of Individuals Covered733
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $20,606
Total amount of fees paid to insurance companyUSD $2,674
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $274,740
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $20,606
Amount paid for insurance broker fees2674
Insurance broker organization code?3
Insurance broker nameGALLAGHER BENEFIT SERVICE
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberLK 962995
Policy instance 1
Insurance contract or identification numberLK 962995
Number of Individuals Covered733
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $19,353
Total amount of fees paid to insurance companyUSD $1,957
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $258,043
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $19,353
Amount paid for insurance broker fees1957
Insurance broker organization code?3
Insurance broker nameGALLAGHER BENEFIT SERVICE
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberLK 962995
Policy instance 1
Insurance contract or identification numberLK 962995
Number of Individuals Covered711
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $24,060
Total amount of fees paid to insurance companyUSD $3,192
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $255,341
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $24,060
Amount paid for insurance broker fees3192
Insurance broker nameGALLAGHER BENEFIT SERVICE
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberLK 962995
Policy instance 1
Insurance contract or identification numberLK 962995
Number of Individuals Covered384
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $16,844
Total amount of fees paid to insurance companyUSD $4,066
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $236,165
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $16,844
Amount paid for insurance broker fees4066
Insurance broker nameGALLAGHER BENEFIT SERVICE
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberLK 952995
Policy instance 1
Insurance contract or identification numberLK 952995
Number of Individuals Covered330
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $1,095
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $14,598
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number072230
Policy instance 1
Insurance contract or identification number072230
Number of Individuals Covered362
Insurance policy start date2010-07-01
Insurance policy end date2010-09-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number862780G
Policy instance 2
Insurance contract or identification number862780G
Number of Individuals Covered362
Insurance policy start date2010-10-01
Insurance policy end date2011-09-30
Total amount of commissions paid to insurance brokerUSD $5,459
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number072230
Policy instance 1
Insurance contract or identification number072230
Number of Individuals Covered364
Insurance policy start date2010-07-01
Insurance policy end date2010-09-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $979
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number862780G
Policy instance 2
Insurance contract or identification number862780G
Number of Individuals Covered370
Insurance policy start date2010-07-01
Insurance policy end date2010-09-30
Total amount of commissions paid to insurance brokerUSD $1,497
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $13,305
Commission paid to Insurance BrokerUSD $1,497
Insurance broker organization code?3
Insurance broker nameUNISON, INC.

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