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| Plan Name | ST. MARYS/DULUTH CLINIC HEALTH SYSTEM LIFE INSURANCE PLAN |
| Plan identification number | 510 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | ST. MARYS - DULUTH CLINIC HEALTH SYSTEM |
| Employer identification number (EIN): | 411836633 |
| NAIC Classification: | 622000 |
| NAIC Description: | Hospitals |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 510 | 2011-01-01 | DIANE DAVIDSON | DIANE DAVIDSON | 2012-07-09 | |
| 510 | 2009-01-01 | DIANE T DAVIDSON | DIANE T DAVIDSON | 2010-10-06 |
| Measure | Date | Value |
|---|---|---|
| 2011: ST. MARYS/DULUTH CLINIC HEALTH SYSTEM LIFE INSURANCE PLAN 2011 401k membership | ||
| Total participants, beginning-of-year | 2011-01-01 | 6,239 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-01-01 | 0 |
| Number of retired or separated participants receiving benefits | 2011-01-01 | 0 |
| Total of all active and inactive participants | 2011-01-01 | 0 |
| 2009: ST. MARYS/DULUTH CLINIC HEALTH SYSTEM LIFE INSURANCE PLAN 2009 401k membership | ||
| Total participants, beginning-of-year | 2009-01-01 | 5,968 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-01-01 | 5,936 |
| Number of retired or separated participants receiving benefits | 2009-01-01 | 8 |
| Number of other retired or separated participants entitled to future benefits | 2009-01-01 | 0 |
| Total of all active and inactive participants | 2009-01-01 | 5,944 |
| 2011: ST. MARYS/DULUTH CLINIC HEALTH SYSTEM LIFE INSURANCE PLAN 2011 form 5500 responses | ||
|---|---|---|
| 2011-01-01 | Type of plan entity | Single employer plan |
| 2011-01-01 | Submission has been amended | No |
| 2011-01-01 | This submission is the final filing | Yes |
| 2011-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2011-01-01 | Plan is a collectively bargained plan | Yes |
| 2011-01-01 | Plan funding arrangement – Insurance | Yes |
| 2011-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2009: ST. MARYS/DULUTH CLINIC HEALTH SYSTEM LIFE INSURANCE PLAN 2009 form 5500 responses | ||
| 2009-01-01 | Type of plan entity | Single employer plan |
| 2009-01-01 | Submission has been amended | No |
| 2009-01-01 | This submission is the final filing | No |
| 2009-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2009-01-01 | Plan is a collectively bargained plan | No |
| 2009-01-01 | Plan funding arrangement – Insurance | Yes |
| 2009-01-01 | Plan benefit arrangement – Insurance | Yes |
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