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LONG TERM DISSABILITY 401k Plan overview

Plan NameLONG TERM DISSABILITY
Plan identification number 503

LONG TERM DISSABILITY Benefits

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

401k Sponsoring company profile

PUERTO RICO HOSPITAL SUPPLY, INC. has sponsored the creation of one or more 401k plans.

Company Name:PUERTO RICO HOSPITAL SUPPLY, INC.
Employer identification number (EIN):660388425
NAIC Classification:339110

Form 5500 Filing Information

Submission information for form 5500 for 401k plan LONG TERM DISSABILITY

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5032019-05-01
5032018-05-01YARITZA ROMAN2019-08-05
5032018-05-01
5032017-05-01NELIDA SANTANA NELIDA SANTANA2018-09-19
5032016-05-01NELIDA SANTANA NELIDA SANTANA2017-10-24
5032015-05-01NELIDA SANTANA NELIDA SANTANA2016-10-14
5032013-05-01NELIDA SANTANA NELIDA SANTANA2014-08-27
5032012-05-01NELIDA SANTANA NELIDA SANTANA2013-09-26

Plan Statistics for LONG TERM DISSABILITY

401k plan membership statisitcs for LONG TERM DISSABILITY

Measure Date Value
2019: LONG TERM DISSABILITY 2019 401k membership
Total participants, beginning-of-year2019-05-0162
Total number of active participants reported on line 7a of the Form 55002019-05-0155
Total of all active and inactive participants2019-05-0155
Total participants2019-05-0155
2018: LONG TERM DISSABILITY 2018 401k membership
Total participants, beginning-of-year2018-05-0184
Total number of active participants reported on line 7a of the Form 55002018-05-0162
Total of all active and inactive participants2018-05-0162
Total participants2018-05-0162
2017: LONG TERM DISSABILITY 2017 401k membership
Total participants, beginning-of-year2017-05-0184
Total number of active participants reported on line 7a of the Form 55002017-05-0164
Total of all active and inactive participants2017-05-0164
Total participants2017-05-0164
2016: LONG TERM DISSABILITY 2016 401k membership
Total participants, beginning-of-year2016-05-0192
Total number of active participants reported on line 7a of the Form 55002016-05-0184
Total of all active and inactive participants2016-05-0184
Total participants2016-05-0184
2015: LONG TERM DISSABILITY 2015 401k membership
Total participants, beginning-of-year2015-05-01230
Total number of active participants reported on line 7a of the Form 55002015-05-0192
Total of all active and inactive participants2015-05-0192
Total participants2015-05-0192
2013: LONG TERM DISSABILITY 2013 401k membership
Total participants, beginning-of-year2013-05-01233
Total number of active participants reported on line 7a of the Form 55002013-05-01225
Total of all active and inactive participants2013-05-01225
Total participants2013-05-01225
2012: LONG TERM DISSABILITY 2012 401k membership
Total participants, beginning-of-year2012-05-01233
Total number of active participants reported on line 7a of the Form 55002012-05-01233
Total of all active and inactive participants2012-05-01233
Total participants2012-05-01233

Form 5500 Responses for LONG TERM DISSABILITY

2019: LONG TERM DISSABILITY 2019 form 5500 responses
2019-05-01Type of plan entitySingle employer plan
2019-05-01Submission has been amendedNo
2019-05-01This submission is the final filingNo
2019-05-01This return/report is a short plan year return/report (less than 12 months)No
2019-05-01Plan is a collectively bargained planNo
2019-05-01Plan funding arrangement – InsuranceYes
2019-05-01Plan benefit arrangement – InsuranceYes
2018: LONG TERM DISSABILITY 2018 form 5500 responses
2018-05-01Type of plan entitySingle employer plan
2018-05-01Submission has been amendedNo
2018-05-01This submission is the final filingNo
2018-05-01This return/report is a short plan year return/report (less than 12 months)No
2018-05-01Plan is a collectively bargained planNo
2018-05-01Plan funding arrangement – InsuranceYes
2018-05-01Plan benefit arrangement – InsuranceYes
2017: LONG TERM DISSABILITY 2017 form 5500 responses
2017-05-01Type of plan entitySingle employer plan
2017-05-01Submission has been amendedNo
2017-05-01This submission is the final filingNo
2017-05-01This return/report is a short plan year return/report (less than 12 months)No
2017-05-01Plan is a collectively bargained planNo
2017-05-01Plan funding arrangement – InsuranceYes
2017-05-01Plan benefit arrangement – InsuranceYes
2016: LONG TERM DISSABILITY 2016 form 5500 responses
2016-05-01Type of plan entitySingle employer plan
2016-05-01Submission has been amendedNo
2016-05-01This submission is the final filingNo
2016-05-01This return/report is a short plan year return/report (less than 12 months)No
2016-05-01Plan is a collectively bargained planNo
2016-05-01Plan funding arrangement – InsuranceYes
2016-05-01Plan benefit arrangement – InsuranceYes
2015: LONG TERM DISSABILITY 2015 form 5500 responses
2015-05-01Type of plan entitySingle employer plan
2015-05-01Submission has been amendedNo
2015-05-01This submission is the final filingNo
2015-05-01This return/report is a short plan year return/report (less than 12 months)No
2015-05-01Plan is a collectively bargained planNo
2015-05-01Plan funding arrangement – InsuranceYes
2015-05-01Plan benefit arrangement – InsuranceYes
2013: LONG TERM DISSABILITY 2013 form 5500 responses
2013-05-01Type of plan entitySingle employer plan
2013-05-01Submission has been amendedNo
2013-05-01This submission is the final filingNo
2013-05-01This return/report is a short plan year return/report (less than 12 months)No
2013-05-01Plan is a collectively bargained planNo
2013-05-01Plan funding arrangement – InsuranceYes
2013-05-01Plan benefit arrangement – InsuranceYes
2012: LONG TERM DISSABILITY 2012 form 5500 responses
2012-05-01Type of plan entitySingle employer plan
2012-05-01First time form 5500 has been submittedYes
2012-05-01Submission has been amendedNo
2012-05-01This submission is the final filingNo
2012-05-01This return/report is a short plan year return/report (less than 12 months)No
2012-05-01Plan is a collectively bargained planNo
2012-05-01Plan funding arrangement – InsuranceYes
2012-05-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

UNIVERSAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60041 )
Policy contract numberLTD 1205-0290
Policy instance 1
Insurance contract or identification numberLTD 1205-0290
Number of Individuals Covered55
Insurance policy start date2019-05-01
Insurance policy end date2020-04-30
Total amount of commissions paid to insurance brokerUSD $1,526
Are there contracts with allocated funds for individual policies?0
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,526
Additional information about fees paid to insurance brokerBROKER
Insurance broker organization code?3
UNIVERSAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60041 )
Policy contract numberLTD12050290
Policy instance 1
Insurance contract or identification numberLTD12050290
Number of Individuals Covered64
Insurance policy start date2017-05-01
Insurance policy end date2018-04-30
Total amount of commissions paid to insurance brokerUSD $1,748
Are there contracts with allocated funds for individual policies?0
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,748
Additional information about fees paid to insurance brokerBROKER
Insurance broker organization code?3
Insurance broker nameCHAPEL & ASSOCIATE INC

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