DAVIS HEALTH SYSTEM INC has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan DAVIS HEALTH SYSTEM GROUP ACCIDENTAL DEATH AND DISMEMBERMENT PLAN
401k plan membership statisitcs for DAVIS HEALTH SYSTEM GROUP ACCIDENTAL DEATH AND DISMEMBERMENT PLAN
| Measure | Date | Value |
|---|
| 2016: DAVIS HEALTH SYSTEM GROUP ACCIDENTAL DEATH AND DISMEMBERMENT PLAN 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-01-01 | 120 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-01-01 | 0 |
| Total of all active and inactive participants | 2016-01-01 | 0 |
| 2015: DAVIS HEALTH SYSTEM GROUP ACCIDENTAL DEATH AND DISMEMBERMENT PLAN 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-01-01 | 130 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-01-01 | 120 |
| Total of all active and inactive participants | 2015-01-01 | 120 |
| 2014: DAVIS HEALTH SYSTEM GROUP ACCIDENTAL DEATH AND DISMEMBERMENT PLAN 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-01-01 | 200 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-01-01 | 194 |
| Total of all active and inactive participants | 2014-01-01 | 194 |
| 2013: DAVIS HEALTH SYSTEM GROUP ACCIDENTAL DEATH AND DISMEMBERMENT PLAN 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-01-01 | 226 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-01-01 | 200 |
| Total of all active and inactive participants | 2013-01-01 | 200 |
| 2012: DAVIS HEALTH SYSTEM GROUP ACCIDENTAL DEATH AND DISMEMBERMENT PLAN 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-01-01 | 286 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-01-01 | 263 |
| Total of all active and inactive participants | 2012-01-01 | 263 |
| 2011: DAVIS HEALTH SYSTEM GROUP ACCIDENTAL DEATH AND DISMEMBERMENT PLAN 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-01-01 | 331 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-01-01 | 287 |
| Total of all active and inactive participants | 2011-01-01 | 287 |
| 2009: DAVIS HEALTH SYSTEM GROUP ACCIDENTAL DEATH AND DISMEMBERMENT PLAN 2009 401k membership |
|---|
| Total participants, beginning-of-year | 2009-01-01 | 469 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-01-01 | 402 |
| Total of all active and inactive participants | 2009-01-01 | 402 |
| 2016: DAVIS HEALTH SYSTEM GROUP ACCIDENTAL DEATH AND DISMEMBERMENT PLAN 2016 form 5500 responses |
|---|
| 2016-01-01 | Type of plan entity | Single employer plan |
| 2016-01-01 | This submission is the final filing | Yes |
| 2016-01-01 | Plan funding arrangement – Insurance | Yes |
| 2016-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2015: DAVIS HEALTH SYSTEM GROUP ACCIDENTAL DEATH AND DISMEMBERMENT PLAN 2015 form 5500 responses |
|---|
| 2015-01-01 | Type of plan entity | Single employer plan |
| 2015-01-01 | Plan funding arrangement – Insurance | Yes |
| 2015-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2014: DAVIS HEALTH SYSTEM GROUP ACCIDENTAL DEATH AND DISMEMBERMENT PLAN 2014 form 5500 responses |
|---|
| 2014-01-01 | Type of plan entity | Single employer plan |
| 2014-01-01 | Plan funding arrangement – Insurance | Yes |
| 2014-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2013: DAVIS HEALTH SYSTEM GROUP ACCIDENTAL DEATH AND DISMEMBERMENT PLAN 2013 form 5500 responses |
|---|
| 2013-01-01 | Type of plan entity | Single employer plan |
| 2013-01-01 | Plan funding arrangement – Insurance | Yes |
| 2013-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2012: DAVIS HEALTH SYSTEM GROUP ACCIDENTAL DEATH AND DISMEMBERMENT PLAN 2012 form 5500 responses |
|---|
| 2012-01-01 | Type of plan entity | Single employer plan |
| 2012-01-01 | Plan funding arrangement – Insurance | Yes |
| 2012-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2011: DAVIS HEALTH SYSTEM GROUP ACCIDENTAL DEATH AND DISMEMBERMENT PLAN 2011 form 5500 responses |
|---|
| 2011-01-01 | Type of plan entity | Single employer plan |
| 2011-01-01 | Plan funding arrangement – Insurance | Yes |
| 2011-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2009: DAVIS HEALTH SYSTEM GROUP ACCIDENTAL DEATH AND DISMEMBERMENT PLAN 2009 form 5500 responses |
|---|
| 2009-01-01 | Type of plan entity | Single employer plan |
| 2009-01-01 | This submission is the final filing | No |
| 2009-01-01 | Plan funding arrangement – Insurance | Yes |
| 2009-01-01 | Plan benefit arrangement – Insurance | Yes |
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | ETB108725 |
| Policy instance | 1 |
| Insurance contract or identification number | ETB108725 | | Insurance policy start date | 2014-02-01 | | Insurance policy end date | 2015-01-31 | | Total amount of commissions paid to insurance broker | USD $615 | | Total amount of fees paid to insurance company | USD $0 | | Other welfare benefits provided | BUSINESS TRAVEL ACCIDENT | | Welfare Benefit Premiums Paid to Carrier | USD $4,100 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $615 | | Insurance broker organization code? | 4 | | Insurance broker name | ALLEGHENY INS SERVICES |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | OK-963594 |
| Policy instance | 1 |
| Insurance contract or identification number | OK-963594 | | Number of Individuals Covered | 200 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Total amount of commissions paid to insurance broker | USD $2,156 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Other welfare benefits provided | EXTENDED AD&D, PARALYSIS | | Welfare Benefit Premiums Paid to Carrier | USD $21,553 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,078 | | Insurance broker organization code? | 3 | | Insurance broker name | NATIONAL BENEFITS GROUP |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | OK-963594 |
| Policy instance | 1 |
| Insurance contract or identification number | OK-963594 | | Number of Individuals Covered | 263 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | Total amount of commissions paid to insurance broker | USD $2,300 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Other welfare benefits provided | EXTENDED AD&D, PARALYSIS | | Welfare Benefit Premiums Paid to Carrier | USD $22,993 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,150 | | Insurance broker organization code? | 3 | | Insurance broker name | NATIONAL BENEFITS GROUP |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | OK-963594 |
| Policy instance | 1 |
| Insurance contract or identification number | OK-963594 | | Number of Individuals Covered | 287 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2011-12-31 | | Total amount of commissions paid to insurance broker | USD $2,398 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Other welfare benefits provided | EXTENDED AD&D, PARALYSIS | | Welfare Benefit Premiums Paid to Carrier | USD $23,987 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | OK-963594 |
| Policy instance | 1 |
| Insurance contract or identification number | OK-963594 | | Number of Individuals Covered | 385 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-12-31 | | Total amount of commissions paid to insurance broker | USD $3,402 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Other welfare benefits provided | EXTENDED AD&D, PARALYSIS | | Welfare Benefit Premiums Paid to Carrier | USD $34,025 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,701 | | Insurance broker organization code? | 3 | | Insurance broker name | NATIONAL BENEFITS GROUP |
|
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