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| Plan Name | LONG TERM DISABILITY |
| Plan identification number | 503 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | INDIAN RIVER MEMORIAL HOSPITAL, INC. D/B/A INDIAN RIVER MEDICAL CENTER |
| Employer identification number (EIN): | 592496294 |
| NAIC Classification: | 622000 |
| NAIC Description: | Hospitals |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 503 | 2012-10-01 | JOHN F. PEEPLES | |||
| 503 | 2011-10-01 | JOHN PEEPLES | JOHN PEEPLES | 2013-04-15 | |
| 503 | 2009-10-01 | JOHN PEEPLES |
| Measure | Date | Value |
|---|---|---|
| 2012: LONG TERM DISABILITY 2012 401k membership | ||
| Total participants, beginning-of-year | 2012-10-01 | 658 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-10-01 | 0 |
| Number of retired or separated participants receiving benefits | 2012-10-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2012-10-01 | 0 |
| Total of all active and inactive participants | 2012-10-01 | 0 |
| 2011: LONG TERM DISABILITY 2011 401k membership | ||
| Total participants, beginning-of-year | 2011-10-01 | 704 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-10-01 | 658 |
| Number of retired or separated participants receiving benefits | 2011-10-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2011-10-01 | 0 |
| Total of all active and inactive participants | 2011-10-01 | 658 |
| 2009: LONG TERM DISABILITY 2009 401k membership | ||
| Total participants, beginning-of-year | 2009-10-01 | 818 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-10-01 | 758 |
| Total of all active and inactive participants | 2009-10-01 | 758 |
| 2012: LONG TERM DISABILITY 2012 form 5500 responses | ||
|---|---|---|
| 2012-10-01 | Type of plan entity | Single employer plan |
| 2012-10-01 | Submission has been amended | No |
| 2012-10-01 | This submission is the final filing | Yes |
| 2012-10-01 | This return/report is a short plan year return/report (less than 12 months) | Yes |
| 2012-10-01 | Plan is a collectively bargained plan | No |
| 2012-10-01 | Plan funding arrangement – Insurance | Yes |
| 2012-10-01 | Plan benefit arrangement – Insurance | Yes |
| 2011: LONG TERM DISABILITY 2011 form 5500 responses | ||
| 2011-10-01 | Type of plan entity | Single employer plan |
| 2011-10-01 | Submission has been amended | No |
| 2011-10-01 | This submission is the final filing | No |
| 2011-10-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2011-10-01 | Plan is a collectively bargained plan | No |
| 2011-10-01 | Plan funding arrangement – Insurance | Yes |
| 2011-10-01 | Plan benefit arrangement – Insurance | Yes |
| 2009: LONG TERM DISABILITY 2009 form 5500 responses | ||
| 2009-10-01 | Type of plan entity | Single employer plan |
| 2009-10-01 | Plan funding arrangement – Insurance | Yes |
| 2009-10-01 | Plan benefit arrangement – Insurance | Yes |